臺灣博碩士論文加值系統

脊椎壓迫性骨折為現今越來越常見的一個疾病。而引起脊椎壓迫性骨折的原因以骨質疏鬆為最主要因素，因為骨質疏鬆會使得骨頭脆弱增加骨折的危險。近年來，脊椎整形術開始被應用在治療壓迫性脊椎骨折方面。脊椎整形術的原理就是將骨水泥打入骨折部位去穩固它，達到紓解疼痛的效果。目前最常使用的骨水泥是PMMA，但是仍有一些缺點，如：不是生物降解性材料、聚合溫度過高、強度過強等。

高分子poly(propylene fumarate)具有低聚合溫度、生物可降解性、可當作注射型骨水泥應用。而磷酸鈣鹽水泥（calcium phosphate cements,CPC），具有相當高的生物相容性，可直接參與骨頭重建的過程。因此在本研究中，我們將兩者混合使用，希望能研發出新型的可注射式骨水泥，用於脊椎整形術，提供穩固的基本強度。

本實驗主要是要探討添加了CPC之後，對水泥強度、聚合溫度、裂解時間的影響。由實驗結果顯示，我們的水泥聚合時溫度在38~44℃間遠低於PMMA的聚合溫度（74℃）。初期強度具有61.1±3.7MPa，而經過了八週的裂解，強度依然都在58~60MPa±10MPa，比起PMMA有更相似於骨頭的強度。由此結果可顯示，我們開發出具有良好機械性質的可降解式骨水泥，可望在未來提供醫師施行在脊椎整形術上。

Vertebral compression fractures are quite common in worldwide. The most common cause is osteoporosis, which causes bone fragility and predisposes the bone to fractures. Vertebroplasty has been widely adopted to treat vertebral body compression fractures. Vertebroplasty, where bone cement is injected into the weakened vertebrae to stabilize them .Currently, the most commonly used injectable bone cement is poly(methyl methacrylate) (PMMA), but it suffers from the fact that it is not degraded and high curing temperature.
Several advantages of PPF has been investigated, including：low crosslinking temperature, biodegradable, injectable . Calcium phosphate cements（CPC）has good biocompatibility and offers the potential for resorption of the cement over time and replacement with new bone .In this study, we want to develop an injectable, biodegradeable bone cement which well be mixed PPF and CPC together. This composite can be used to fill skeletal defects, acting as a mechanical support at the defect site.
The purpose of this study was to evaluate the effect of the incorporation of calcium phosphate cement filler on the degradation time, highest crosslinking temperature and compressive strength, respectively. Result show that the highest crosslinking temperature with the absolute values ranging from 38° to 44°C, which was much lower than that of 74°C for poly(methyl methacrylate) bone cement. The value of initial compressive strength was 61.1±3.7 MPa,and the level of compressive strength still in the range of 50~60±10 MPa after 8 weeks. Compare with PMMA, the compressive strength of new bone cement was more similar with native bone tissue. and could lasted over 2 months. Data shown that we have developed degradeable bone cement with well mechanical property and may applied in Vertebroplasty

目 錄
中文摘要----------------------------------------------------------------------------------I
Abstract-----------------------------------------------------------------------------------II
目錄--------------------------------------------------------------------------------------IV
圖目錄----------------------------------------------------------------------------------VII
表目錄------------------------------------------------------------------------------------X

第一章 簡介-----------------------------------------------------------------------------1
1.1 前言---------------------------------------------------------------------------------- 1
1.2脊椎的基礎構造及功能------------------------------------------------------------3
1.3骨骼的代謝和生長------------------------------------------------------------------6
1.4骨質疏鬆症---------------------------------------------------------------------------8
1.5現今治療壓迫性骨折之概況----------------------------------------------------11
1.6現今治療壓迫性骨折之新進展-------------------------------------------------13
1.7 現行骨水泥之性質---------------------------------------------------------------15
1.8 研究動機與目的------------------------------------------------------------------18
第二章 基本理論----------------------------------------------------------------------19
2.1 poly(propylene fumarate) (PPF)概述-------------------------------------------19
2.1.1 poly(propylene fumarate)的合成及結構--------------------------------19
2.1.2 poly(propylene fumarate)的基本性質-----------------------------------21
2.1.3 高分子裂解機制-----------------------------------------------------------22
2.2 α-TCP/HAP的製備原理----------------------------------------------------------24
2.2.1氫氧基磷灰石（HAP）的製備----------------------------------------------24
2.2.2 HAP轉變成α-TCP/HAP雙相材料的原理------------------------------26
2.3 α-TCP/HAP雙相材料的固化機制----------------------------------------------27
第三章 實驗步驟與方法-------------------------------------------------------------28
3.1 實驗儀器---------------------------------------------------------------------------29
3.2 實驗藥品---------------------------------------------------------------------------30
3.3 材料製備---------------------------------------------------------------------------31
3.3.1 氫氧基磷灰石粉末合成--------------------------------------------------31
3.3.2 α-TCP/HAP雙相粉末合成------------------------------------------------32
3.3.3 poly(propylene fumarate)（PPF）製備------------------------------------33
3.3.4 PPF的純化-------------------------------------------------------------------35
3.3.5 骨水泥樣本製備-----------------------------------------------------------36
3.4 材料性質分析---------------------------------------------------------------------38
3.4.1 XRD分析---------------------------------------------------------------------38
3.4.2 NMR分析--------------------------------------------------------------------39
3.4.3 GPC分析---------------------------------------------------------------------39
3.5 骨水泥性質測試------------------------------------------------------------------40
3.5.1 聚合溫度測試--------------------------------------------------------------40
3.5.2 體外裂解測試--------------------------------------------------------------40
3.5.3 抗壓強度測試--------------------------------------------------------------41
3.5.4 重量損失測試--------------------------------------------------------------41
3.5.5 SEM分析---------------------------------------------------------------------41
3.5.6 X光不穿透性測試----------------------------------------------------------43
3.6 材料滅菌方式---------------------------------------------------------------------43
3.7 骨髓瘤細胞分離及培養---------------------------------------------------------43
3.8 生物相容性測試------------------------------------------------------------------44
3.8.1 WST-1細胞活性測試------------------------------------------------------44
3.8.2 LDH細胞毒性測試---------------------------------------------------------45
3.8.3骨水泥聚合之細胞毒性測試----------------------------------------------46
第四章 結果----------------------------------------------------------------------------48
4.1 材料定性分析---------------------------------------------------------------------48
4.2 骨水泥性質分析------------------------------------------------------------------52
4.3 生物相容性測試------------------------------------------------------------------60
第五章 討論----------------------------------------------------------------------------66
第六章 結論----------------------------------------------------------------------------69
附錄A.U2-OS細胞株資料------------------------------------------------------------70
參考文獻--------------------------------------------------------------------------------71

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