复合降解膜对异体神经再生的影响

Influence of combined-degradable membrane on neural regeneration after allograft

目的:探讨抑制结缔组织增生的复合降解膜对异体神经再生作用。方法:实验于2003-04/2004-04在沈阳医学院附属奉天医院动物实验室完成。选取SD大鼠60只随机分成干预组、对照组和正常组,每组20只。用20g/L戊巴比妥钠25mg/kg腹腔麻醉后,将大鼠左下肢坐骨神经切除2cm,用同种异体坐骨神经移植。干预组在神经移植处置入包裹含有抑制胶原纤维合成试剂的降解膜;对照组在神经移植处置入不含试剂的降解膜;正常组在神经移植处不放任何膜。术后180d取材标本制作,并测定各组大鼠神经植入处有髓神经纤维数量、直径,神经近端缝合处胶原纤维数量、羟脯氨酸含量,各组大鼠坐骨神经支配腓肠肌的潜伏期及波幅等。结果:60只实验动物均纳入结果分析。再生坐骨神经纤维的数量、直径以及电生理的潜伏期和波幅等指标上,均明显较不置药的对照组和正常组的多、粗、恢复快、短而大。干预组和对照组胶原纤维数量分别为(521±135,1020±133)条,两组比较有显著性差异(t=-11.833,P<0.05);干预组羟脯氨酸含量较正常组低[(13.13±3.36,21.72±2.85)ug/g,(t=-5.374,P<0.05)];对照组羟氨酸含量(20.65±2.83)ug/g,与正常组(21.72±2.85)ug/g比较差异无显著性意义(t=-0.798,P>0.05)。维生素正常浓度明显较对照组和正常组低。干预组术后潜伏期明显小于对照组与正常组(P<0.05),波幅明显大于对照组和正常组(P<0.005)。结论:抑制结缔组织增生的复合降解膜有提高同种异体神经移植的再生作用。

AIM： To study the effect of combined-degradable membrane on nerve regeneration following allograft. METHODS： The experiment was carried out in the animal laboratory, Fengtian Hospital of Shenyang Medical College from April 2003 to April 2004. Sixty SD rats were randomized into interventional group, control group and normal group with 20 rats in each group. Rats were anesthetized intraperitoneally with 20 g/L soluble pentobarbitone （20 mg/kg） to cut 2-cm sciatic nerve segment from left lower extremities mstead of sciatic nerve allograft. Degradable membrane containing the reagent against synthesis of collagen fibers was implanted in the interventional group, and the membrane without the reagent was implanted in the control group. No membrane was implanted in the normal group. After 180 days, the number and diameter of myelinated nerve fibers in implanted area, and the number of collagen fibers and hydroxyproline content in the proximal suture area were measured in the three groups as well as the latency and wave amplitude of gastrocnemius muscle. RESULTS： All the 60 rats were involved in the result analysis. The number and diameter of regenerated sciatic nerve fibers, the latency and the amplitude in the interventional group were more, thicker, shorter and lower, respectively, as compared with the control and normal groups. The number of collagen fibers in the interventional group was 521±135, significandy less than 1 020±133 in the control group（t=-11.833, P 〈 0.05）. As compared with the normal group, the bydroxyproline content was lower in the interventional group[（13.13±3.36） vs （21.72±2.85） ug/g, t=-5.374, P 〈 0.05], while there was no difference between the control group and normal group[（20.65±2.83） ug/g vs （21.72±2.85） ug/g, t=-0.798, P 〉 0.05]. As compared with the control and normal group, vitamin content was lower, the latency was significantly shorter（P 〈 0.05）, and the amplitude was obviously larger in the interventional group（P 〈 0.005）. CONCLUSION： Combined-degradable membrane with the inhibition effect on connective tissue proliferation can promote the regeneration of allograft nerve.