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钙磷酸盐:有何证据?

Calcium phosphates: what is the evidence?

机构信息

Department of Orthopaedic Surgery, Uppsala University, Uppsala, Sweden.

出版信息

J Orthop Trauma. 2010 Mar;24 Suppl 1:S41-5. doi: 10.1097/BOT.0b013e3181cec472.

Abstract

A number of different calcium phosphate compounds such as calcium phosphate cements and solid beta-tricalcium phosphate products have been introduced during the last decade. The chemical composition mimics the mineral phase of bone and as a result of this likeness, the materials seem to be remodeled as for normal bone through a cell-mediated process that involves osteoclastic activity. This is a major difference when compared with, for instance, calcium sulphate compounds that after implantation dissolve irrespective of the new bone formation rate. Calcium phosphates are highly biocompatible and in addition, they act as synthetic osteoconductive scaffolds after implantation in bone. When placed adjacent to bone, osteoid is formed directly on the surface of the calcium phosphate with no soft tissue interposed. Remodeling is slow and incomplete, but by adding more and larger pores, like in ultraporous beta-tricalcium phosphate, complete or nearly complete resorption can be achieved. The indications explored so far include filling of metaphyseal fracture voids or bone cysts, a volume expander in conjunction with inductive products, and as a carrier for various growth factors and antibiotics. Calcium phosphate compounds such as calcium phosphate cement and beta-tricalcium phosphate will most certainly be part of the future armamentarium when dealing with fracture treatment. It is reasonable to believe that we have so far only seen the beginning when it comes to clinical applications.

摘要

在过去的十年中,已经引入了许多不同的磷酸钙化合物,例如磷酸钙水泥和固体β-磷酸三钙产品。其化学成分模拟了骨的矿物质相,因此,这些材料似乎通过涉及破骨细胞活性的细胞介导过程被重塑为正常骨。与硫酸钙化合物相比,这是一个主要区别,例如,硫酸钙化合物在植入后会溶解,而不管新骨形成率如何。磷酸钙具有高度的生物相容性,此外,它们在植入骨中充当合成骨传导支架。当放置在骨旁时,直接在磷酸钙表面形成类骨质,没有软组织介入。重塑缓慢且不完全,但通过添加更多和更大的孔,如在超多孔β-磷酸三钙中,可以实现完全或几乎完全吸收。迄今为止探索的适应症包括填充干骺端骨折空隙或骨囊肿、与诱导产品结合的体积扩张剂,以及作为各种生长因子和抗生素的载体。磷酸钙化合物,如磷酸钙水泥和β-磷酸三钙,在处理骨折治疗时肯定将成为未来武器库的一部分。可以合理地认为,就临床应用而言,我们目前还只是处于起步阶段。

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