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金属学报  2017, Vol. 53 Issue (10): 1284-1302    DOI: 10.11900/0412.1961.2017.000269
  研究论文 本期目录 | 过刊浏览 |
兼具成骨和抗感染性能的医用金属材料研究进展
林潇1, 葛隽1, 吴水林2, 刘宝华3, 杨惠林1,4, 杨磊1,4()
1苏州大学骨科研究所 苏州 215006
2 湖北大学材料科学与工程学院 武汉 430062
3 深圳大学医学部基础医学院 深圳 518060
4 苏州大学国际骨转化医学联合研究中心 苏州 215006
Advances in Metallic Biomaterials with both Osteogenic and Anti-Infection Properties
Xiao LIN1, Jun GE1, Shuilin WU2, Baohua LIU3, Huilin YANG1,4, Lei YANG1,4()
1 Institute of Orthopaedics, Soochow University, Suzhou 215006, China
2 School of Materials Science and Engineering, Hubei University, Wuhan 430062, China
3 Department of Basic Medical Sciences, School of Medicine, Shenzhen University, Shenzhen 518060, China
4 International Research Center for Translational Orthopaedics (IRCTO), Soochow University, Suzhou 215006, China
引用本文:

林潇, 葛隽, 吴水林, 刘宝华, 杨惠林, 杨磊. 兼具成骨和抗感染性能的医用金属材料研究进展[J]. 金属学报, 2017, 53(10): 1284-1302.
Xiao LIN, Jun GE, Shuilin WU, Baohua LIU, Huilin YANG, Lei YANG. Advances in Metallic Biomaterials with both Osteogenic and Anti-Infection Properties[J]. Acta Metall Sin, 2017, 53(10): 1284-1302.

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摘要: 

材料的成骨性能(即材料表面或周围促进新骨生成的性能)一直以来是大部分骨科植入性医疗器械的首要临床要求。近年来,材料的抗感染或者抗菌性能(尤其是不依赖抗生素的抗感染或者抗菌性能)逐渐成为骨科植入物的另一重要临床要求。因此,开发同时具有成骨和抗感染性能的生物材料对于骨科临床具有重要意义。医用金属材料在骨科植入物中占有重要地位,但兼具这2种性能的金属材料在以往的临床实践或基础研究中都极为少见,最近才得以广泛研究。本文综述了同时具有成骨和抗感染性能的新型医用金属材料的研究进展,介绍相关金属材料以及金属材料表面改性的研究成果,并对材料兼具成骨和抗感染的机理进行分析讨论,提出此类新型医用金属材料的研究展望。
关键词 ： 医用金属材料,  表面改性,  成骨性能,  抗感染,  抗菌    
Abstract：

Osteogenic capacity (i.e., properties that promote new bone formation around the implant) has long been a clinical requirement for most orthopedic implants. Recently, anti-infection or antibacterial property has increasingly become critical for orthopedic implants (especially without the use of antibiotics). Orthopedic implant materials with simultaneous osteogenic and anti-infection capacities are extremely promising for orthopedic applications, but such materials are not widely available to date and have only recently been researched. In this review article, the advances in metallic biomaterials with both osteogenic and anti-infection capacities were introduced considering of the wide application of metallic biomaterials in orthopedics. Firstly, numerous attractive metal formulations that exhibit both osteogenic and anti-infection capacities as well as surface modification strategies that enhance such capacities are introduced. Secondly, several possible mechanisms underlying the osteogenic and anti-infection properties are discussed. Finally, an outlook of this field is proposed.
Key words： metallic biomaterial    surface modification    osteogenic    anti-infection    antibacterial
收稿日期: 2017-07-04     
ZTFLH:  R318.08  
基金资助:资助项目 国家自然科学基金项目Nos.81501858、51672184和81622032,江苏省“双创团队”和“双创人才”项目No.BY2014159-07,江苏省高校优势学科建设工程项目(PAPD)
作者简介:

作者简介 林 潇,男,1987年生,讲师,博士
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林潇
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杨惠林
杨磊

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https://www.ams.org.cn/CN/10.11900/0412.1961.2017.000269      或      https://www.ams.org.cn/CN/Y2017/V53/I10/1284

Material
 Composition
 Toxicity
 Biodegradability Mechanical properties
Hardness
HV		 Test
mode		 E
GPa		 YS
MPa		 US
MPa		 EL
%
Ti-Cu alloy[8,9] Ti-5%Cu
(mass fraction)		 N N 369.5 C 1247.0 1707.9 15
Ti-Nb-Ag alloy[10] Ti26Nb5Ag
(atom fraction / %)		 NA N 514 C 1240.5 5.4
Ti-Ag as cast[11,12] Ti-20Ag NA N 250 T 400 550 19
SUS 304-Cu SS[13]
 304SS containing 1.5%~5.5% Cu
(mass fraction)		 NA
 N
 240~270
 T
 570~625
Co-Cr-Mo-Cu[14]
 Co-Cr-Mo with 1%~4% Cu
(mass fraction)		 NA
 N
 274~298
 T
 310~440
 447~620
 10.7~18.5
Pure Mg
as cast[15,16]		 99.9%Mg
(mass fraction)		 Negligible Y 26 T 45 49 93 3
Mg-Ag alloy[17] Mg-2%Ag
(mass fraction)		 Negligible Y 40.1 C 44 225
Mg-Cu alloy
as cast[18]		 Mg-0.03%Cu
(mass fraction)		 N Y 32 T 80
Mg-Nd-Zn-Zr alloy[19-21] Mg-3.130Nd-
0.164Zn-0.413Zr		 Negligible Y T About 333 About 334 About 21
Zn extruded[22] 99.99%Zn
(mass fraction)		 NA Y 25 T 130 About 180 55
Zn-1Mg alloy[22] Zn-0.95%Mg
(mass fraction)		 N Y 70 T 180 250 11
Cortical bone[23] T
C		 8~12 50~130
130~190
表1  兼具成骨和抗感染性能的医用金属材料[8-23]
图1  几种具有成骨和抗感染性能的医用金属材料的微观组织[12,17,18]
图2  Mg-Cu系列合金的成骨和抗感染性能[18]
图3  通过表面改性获得成骨和抗感染性能的典型金属的微观结构[61,66,72,77]
图4  Cu/Zn共掺杂的HA涂层截面和表面形貌[96]
Agent Antibacterial mechanism Biological benefit
Ag Disrupting functions of bacteria to form a nonculturable state[139-141] Not clear
Cu
 Generation of reactive oxygen species[142];
Formation of cavities in the bacterial cell wall[143]		 Preventing osteoporosis[144,145];
Promoting osteogenic differentiation[146];
Inducing vascularization[147-149]
Zn

 Generation of reactive oxygen species[150];
Excessive uptake of Zn ions[151];
Inhibition of bacterial activities[152]		 Synthesis and stabilization of proteins[153];
Constituent of antioxidant system[154];
Anti-inflammatory effect[113];
Bone formation and vascularization[113,155,156]
Chi
 Chi/bacteria electrostatic interactions resulting in growth inhibition[157] and causing the leakage of intracellular constituents[158] Promoting growth and mineral rich matrix deposition of osteoblasts[159];
Accelerating osteogenic differentiation[122,123]
AP Disrupting the integrity of microbial membranes and subsequent cell lysis[160,161] Angiogenesis, modulation of cytokine/chemokine expression, wound healing[162,163]
表2  常见抗菌医用材料的抗菌机理及生物学功能[113,122,123,139-163]
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