中文摘要：

背景：传统口服抗生素治疗因趋化能力弱、剂量难以控制及全身副反应等作用削弱其广泛的应用。载药人工骨长效、定点、可控地释放药物,弥补了系统抗生素治疗的缺陷。目的：通过新型局部给药系统材料,制备及药物释放动力学等方面综合和对比分析,指导以后载药人工骨的研发和选择应用。方法：应用PubMed和Sciencedirect数据库检索2001-01/2011-11关于局部给药系统对骨髓炎及骨缺损治疗相关方面的文献,英文检索词为＂drug delivery system,osteomyelitis,bone defect,bone substitute＂。排除无关及重复性研究,同一领域则选择权威杂志近期发表文献,保留25篇进一步归纳总结。结果与结论：骨的重建与修复需要满足3个条件,即要满足骨诱导、骨传导和骨生成,此外合适的骨组织生长环境也必不可少。根据材料特点将人工骨分为生物陶瓷材料,生物材料,高分子材料,复合材料。也可根据材料的吸收性分为可生物降解型和非生物降解型。载药人工骨局部给药系统靶位点释放药物,具有提供骨良好修复环境与骨诱导的特点。载药骨的药物释放量需对载药浓度选择,局部药物释放时间,感染类型确定药物种类的选择,人工骨材料选择,药物与人工骨是否发生化学反应,对骨材料性质的影响等方面进行比较和控制。

英文摘要：

BACKGROUND：Conventional systemic antibiotic treatment for osteomyelitis limits its wide clinical applications account for comparative low selectivity on target site,unsustainable dosage control,and importantly,the systemic antibiotic side effects.Drug release of drug-load bone substitute exerts a targeted,controlled and long-term effect,and thus offsets side effects of systematic antibiotics treatment.OBJECTIVE：To guide the research,development and selective application of drug-loaded bone substitute by comprehensive and comparative analysis for materials,synthetics and pharmacokinetics of local delivery systems.METHODS：PubMed and Sciencedirect databases were retrieved online from 2001-01 to 2011-11 for relative articles about the treatment of local delivery systems on osteomyelitis and bone defect,with the Key words of ＂drug delivery system,osteomyelitis,bone defect,bone substitute＂ in English.Articles published in authorized journals and updated were selected,while unrelated and repeated articles were excluded.Totally 25 articles were included.RESULTS AND CONCLUSION：Reconstruction and repair of bone tissue requires three conditions：bone induction,bone conduction and bone generation,moreover,suitable nest for the growth of bone tissue is indispensible.Bone substitute can be divided into bioceramic materials,biomaterials,polymer materials and composite according to its material characteristics,and it also can be divided into biodegradable type and non biodegradable type according to material absorbility.Drug release in target site of local delivery systems with drug-load bone substitute has the character of providing appropriate nest and bone induction for bone tissue and making drug delivery system an optimal option.Drug release rate of drug-load bone substitute should be regulated referring to the choice of drug-load density,local drug released time,selection of drug determination for infection type and bone substitute material,chemical reaction whether happened between drug and bone substitute as