外源性血管内皮生长因子结合微骨折术治疗全层关节软骨缺损的实验研究_临床医学论文.docVIP

外源性血管内皮生长因子结合微骨折术治疗全层关节软骨缺损的实验研究_临床医学论文 外源性血管内皮生长因子结合微骨折术治疗全层关节软骨缺损的实验研究_临床医学论文 作者：初涛 陈青 郝清海 魏昌海 【摘要】 目的:探讨外源性血管内皮生长因子(VEGF)结合微骨折术治疗全层关节软骨缺损的实验疗效。方法:24只健康新西兰大白兔,随机分为四组，制作膝关节股骨滑车软骨缺损模型,A组：微骨折+胶原海棉吸附VEGF100μg充填，B组:胶原海绵吸附 VEGF100μg充填，C组:微骨折+胶原海棉充填，D组:胶原海棉充填。术后16周取标本，进行HE染色，甲苯胺蓝染色，Ⅱ型胶原免疫组化染色，以及对16周标本扫描电镜观察软骨生长情况。结果:按Wakitani法评分标准对修复软骨进行评分，所得数据以D组为对照组进行组间两两比较（Dunnett t-tests），A、B、C三组与之比较差异均有统计学意义（0.01）。A、B、C三组间两两比较（LSD法），结果显示A组与B组、C组间差异有统计学意义（0.01），而B组与C组间差异无统计学意义（Pgt;0.05）。结论：1.外源性VEGF和微骨折术均可以促进机体对软骨缺损的修复作用；2.外源性VEGF结合微骨折术能有效修复兔膝关节软骨的全层缺损，为临床治疗提供理论依据。 【关键词】 血管内皮生长因子；骨折；软骨 【ABSTRACT】 Objective:To investigate the experiment on repairing articular cartilage defects by exogenous VEGF in combination with micro-fracture.Methods:24 healthy New Zealand white rabbits were randomly divided into four groups,made cartilage defects of Femoral block on the knee-joint,Rabbits in Group A,by microfracture and collagen sponge adsorption VEGF were filled the cartilage defect,Rabbits in Group B,by collagen sponge adsorption VEGF were filled the cartilage defect,Rabbits in Group C,by microfracture and collagen sponge were filled the cartilage defect, Rabbits in Group D, by collage sponge were filled the cartilage defect.Samples which were taken 16-weeks operation, were for HE staining,Toluidine blue stain,Ⅱ collagen immunohistochemistry,and SEM cartilage growth observation.Results:According to Wakitani criteria standards score for the repair cartilage, D group as control group for comparison(Dunnett t-tests),A、B、C group were compared one another(LSD method),showed that group A、B、C had significant differences（0.01）,group B、C had no significant differences(Pgt;0.05).Conclusion：Exogenous VEGF and micro-fracture on the body can promote the repair of cartilage defects.Exogenous VEGF and micro-fracture combined with micro-fracture can effectly repair the knee cartilage full-thickness defects on rabbits,can provide theoretical basis for clinical. 【KEY WORDS】 Vascular Endothelial Growth Factors,