文献类型：期刊文献

中文题名：负载rhBMP-2性人工骨修复骨缺损的临床应用

英文题名：CLINICAL APPLICATION OF BIOACTIVE CPC LOADING rhBMP-2 IN REPAIRING BONE DEFECTS

作者：周宁峰[1];王金武[1];刘昌胜[2];范存义[1];张麒云[1];薛峰[3];张键[4]

机构：[1]上海交通大学附属第六人民医院骨科,上海200233;[2]华东理工大学生物材料研究所;[3]上海奉贤区中心医院骨科;[4]上海中山医院骨科

年份：2009

卷号：23

期号：3

起止页码：257

中文期刊名：中国修复重建外科杂志

外文期刊名：Chinese Journal of Reparative and Reconstructive Surgery

收录：MEDLINE(收录号：19366127);CSTPCD;;Scopus;北大核心:【北大核心2008】；CSCD:【CSCD2011_2012】；PubMed;

基金：国家杰出青年基金项目(20425621);上海市科学技术委员会基础研究重点项目基金(07JC14035);上海交通大学医工(理)交叉研究基金(YG2007MS01)~~

语种：中文

中文关键词：rhBMP-2;CPC;骨缺损;生物活性;人工骨;修复

外文关键词：rhBMP-2 CPC Bone defects Bioactive Arti cial bone Repair

摘要：目的探讨负载rhBMP-2的CPC活性人工骨修复骨缺损的临床应用,评价其临床使用效果和安全性。方法2006年6月-2007年9月,采用负载rhBMP-2的CPC(rhBMP-2/CPC组)和单纯CPC(对照组)修复骨缺损112例,骨缺损范围为1cm×1cm×1cm～4cm×3cm×3cm。其中对照组63例,男31例,女32例;年龄17～70岁,平均47.4岁。骨缺损部位:跟骨19例,胫骨平台20例,肱骨近端8例,桡骨远端9例,胸腰椎7例。rhBMP-2/CPC组49例,男31例,女18例;年龄16～68岁,平均45.6岁。骨缺损部位:跟骨11例,胫骨平台16例,肱骨近端7例,桡骨远端2例,胫骨远端2例,胸腰椎11例。术中采用负载rhBMP-2/CPC(2～5g)或单纯CPC(2～50g)填充骨缺损。结果术后108例伤口Ⅰ期愈合;术后2周对照组1例及rhBMP-2/CPC组3例伤口有淡黄色清亮稀薄分泌物渗出,经换药及激素治疗后愈合。所有患者未见毒性反应,无皮疹或高热,肝肾功能、血、尿常规及C反应蛋白均正常。112例均获随访,随访时间12～24个月,平均13.2个月。随访期间未发生骨髓炎,无再骨折,无明显骨缺损修复后再塌陷,无钢板及螺钉松动、断裂等并发症,脊柱手术的椎体前缘无高度不足发生。两组术后3个月骨折均达骨性愈合,无延迟愈合或骨不连发生。患肢活动情况良好,屈伸功能达正常活动水平。结论负载rhBMP-2的CPC活性人工骨修复骨缺损安全、有效,是一种理想的骨缺损修复材料。
Objective To investigate the clinical application of self-setting CPC loading rhBMP-2 for repair of bone defects and to evaluate the clinical effect and safety. Methods From June 2006 to September 2007,112 bone defects patients were treated by CPC loading rhBMP-2 （rhBMP-2/CPC group） or CPC （control group）. The range of bone defect was from 1 cm×1 cm×1 cm to 4 cm×3 cm×3 cm. In the control group,63 patients included 31 males and 32 females,aging from 17 to 70 years with an average of 47.4 years. The bone defects were located as follows： calcaneus in 19 patients,tibial plateau in 20 patients,proximal humerus in 8 patients,distal radius in 9 patients and thoracolumbar vertebrae in 7 patients. In the rhBMP-2/CPC group,49 patients included 31 males and 18 females,aging from 16 to 68 years with an average of 45.6 years. The bone defects were located as follows： calcaneus in 11 patients,tibial plateau in 16 patients,proximal humerus in 7 patients,distal radius in 2 patients,distal tibia in 2 patients and thoracolumbar vertebrae in 11 patients. All defects were repaired with rhBMP-2/CPC （2-5 g） and CPC （2-50 g） in the rhBMP-2/CPC group and the control group,respectively. Results A total of 108 patients got primary healing after operation. Incisions oozing light yellow uids were found in 4 patients （control group in 1,rhBMP-2/CPC group in 3）,and then healed through dressing changes and taking glucocorticoid. There were no allergic or toxic reaction,no rush or high fever,no uctuation of hepatic and renal function,blood routine,CRP and urine routine. All patients were followed up for 12 to 24 months （mean 13.2 months）. The X-ray examination showed that the implanted material was rmly bonded to the bone at the interface and the anatomic contour of the bone at the sites of defects was successfully restored,and no ablation occurred. All patients got bone union after 3 months of operation. The movement and function of exion and extension of a ected limbs recovered to the normal level. Conclusion Repairing bone defects with rhBMP-2/CPC is safe and effective. Using rhBMP-2/CPC is a promising therapy to deal with bone defects.