载万古霉素羟基磷灰石抗感染钛钢板的研制.DOCVIP

临床医学论文-载万古霉素羟基磷灰石抗感染钛钢板的研制 ??????????????? 作者：唐良华，赵长虹，潘长江，王远亮，王爱民? 【摘要】? 　　目的 探讨一种携载并缓释万古霉素（VCM）的抗感染骨折内固定钢板的制备；并通过扫描电镜(SEM)、X射线能谱仪(EDX)、红外光谱分析仪（FTIR）等检测其特征、抑菌实验检测其对金黄色葡萄球菌抑制作用等，期望能为临床上预防以及治疗开放性骨折手术后的细菌感染提供一种途径。方法 以羟基磷灰石（HA）为载体，采用仿生溶液（Simulated body fluid，SBF）生长法（Biomimetic growth），在钛合金板基体表面制备了携载VCM的HA抗感染涂层，通过SEM，EDX和FTIR等检测方法对钛钢板表面涂层进行检测；选用金黄色葡萄球菌（S.aureus）作为试验菌，分别观察载VCM-HA缓释钛钢板和载HA钛钢板的体外抗菌效果。结果 钢板表面获得载VCMHA涂层；抑菌试验证明，钢板周围出现明显抑菌圈，表明VCM被成功携载于涂层中。结论 载VCMHA钛钢板能有效的携载万古霉素，且保持了其抑菌活性。 【关键词】? 万古霉素 羟基磷灰石 钢板仿生溶液 金黄色葡萄球菌 涂层??? 　　Abstract:：? Objective? To explore the preparation of an internal fixation plate which can inhibit infection by carrying and slowreleasing vancomycin.By detecting inhibition of staphylococcus aureus in vitro，we hope to provide a way to prevent and treat? bacterial infection after surgery of open fractures.Methods? HA coatings which carry vancomycin were prepared on the surface of titanium plate substrate for fracture fixation by simulated body fluid technology with the HA as a carrier；vancomycinHA loaded plates were detected by the test method of SEM，EDX and FTIR；Bacteriostasis of vancomycinloaded HA plates and blank HA plates were observed with staphylococcus aureus as test organisms.Results? The vancomycinHA loaded coatings were prepared on the plates.The test of bacteriostasis indicated that obvious inhibition zone appeared around the plate.It showed that vancomycin was successfully loaded on the coating.Conclusion? VancomycinHA loaded plates for internal fixation carries vancomycin effectively and keeps? their bacteriostatic activity.??? 　　Key words：vancomycin；hydroxyapatite(HA)；plate staphylococcus aureus；biomimetic method；simulated body fluid；coating??? 　　抗生素缓释系统是近20年来在一系列新的生物相容性较好的无机材料和有机高分子材料基础上逐渐发展起来的，为解决目前常规用药方式效率不高且毒性较大这一缺陷的一种新型局部给药方式，在治疗骨髓炎、骨结核和感染性骨缺损等方面有着广阔的应用前景。目前国外有少量学者探索载抗生素涂层的克氏针、髓内针、钢板等进行骨折后抗感染的治疗。Gollwitzer等［1］尝试以聚D，L乳酸（PDLLA）为缓释载体的载庆大霉素或替考拉宁缓释克氏针，置入2.5×105cfu/ml金黄色葡萄球菌悬液中，与裸露的不锈钢、钛合金或克氏针比较明显减少了吸附的细菌数量（P0.01）。Schmidm