软骨细胞联合BMP/bFGF移植对关节软骨损伤的修复作用

目的：探讨同种异体软骨细胞移植联合骨形态发生蛋白（BMP）/碱性成纤维细胞生长因子（bFGF）对关节软骨损伤的修复作用。方法：取24只14周龄成年大白兔,随机分为A、B、C、D组,每组6只,于双侧膝关节软骨处制作软骨缺损模型,A组采用软骨细胞移植联合应用BMP/bFGF处理,B组采用单纯软骨细胞移植,C组采用单纯BMP/bFGF修复,D组采用磷酸盐缓冲液（PBS）作为阴性对照,于处理后8、12、24周行形态学、电镜观察及组织学评分。结果：8周时,A组关节修复面与周围结合紧密,可见大量软骨细胞出现,电镜下有软骨基质形成;B、C组仅有少量软骨细胞;D组未见修复。12周时,A组关节修复面与周围组织界限模糊,软骨细胞增殖活跃,电镜下可见成熟软骨基质;B、C组修复块周围有肉芽组织生成,电镜下可见未成熟的软骨基质出现;D组可见肉芽组织形成。24周时,A组修复面周围组织融合,电镜下软骨细胞纵行排列;B、C组关节面修复不完全,电镜下软骨细胞分布不均;D组见大量肉芽组织形成。24周时,A组组织学评分（1.87±0.65）,明显低于B组（3.49±0.71）、C组（3.43±0.83）组和D组（13.45±0.97）,差异均有统计学意义（P〈0.05）,B、C组均明显低于D组,差异有统计学意义（P〈0.05）,B、C组之间比较无明显差异。结论：软骨细胞联合BMP/bFGF移植能够促进软骨生长,提高软骨损伤的修复质量。

Recovery Effect of Combined Transplantation with Chondrocyte and BMP/bFGF on the Injury of Articular Cartilage

Objective： To study the recovery effect of combined transplantation with chondrocyte and BMP/bFGF on the injury of articular cartilage.Methods： Twenty-four 14-week-old rabbits were divided into four groups randomly,i.e.group A,B,C and D.Each rabbit was made of the model of cartilage defected in the couple of knees.Group A was transplanted chondrocyte combined BMP/bFGF.Group B was grafted chondrocyte simply.Group C was just injected BMP/bFGF,and Group D was PBS as control.After 8,12,24 weeks of transplantation,evaluatation of morphology,electron-microscope and histology was measured.Results： At the 8th week,transplanted tissue of Group A contacted closely with the surrounding articular surface.A great number of chondrocytes were visible and cartilage matrix could be observed in the electron microscope（EM）.Group B and C had a small number of chondrocyte,and Group D was unrecovered.At the 12th week,the gap between the transplanted and host tissue was indistinct in Group A.The chondrocyte proliferated actively,and mature cartilage matrix appeared in EM.Granulation tissue was formed in Group B and C with immature cartilage matrix in EM.Group D had only granulation tissue.At the 24th week,the transplant of Group A merged into the normal tissue,and the chondrocyte arranged longitudinally in EM.Group B and C recovered incompletely with uneven chondrocyte in EM.Group D formed plenty of granulation tissue.At the 24th week,histological scoring of Group A（1.87±0.65） was significantly lower than those of the Group B（3.49±0.71）,C（3.43±0.83） and D（13.45±0.97）（P0.05）.Group B and C were significantly lower than that of Group D（P 0.05）.No evident difference was observed between Group B and Group C（P0.05）.Conclusion： Combined transplantation with chondrocyte and BMP/bFGF could promote the growth of cartilage and increase the quality of restored cartilage.