核心蛋白聚糖抑制兔屈趾肌腱术后粘连的实验研究

EXPERIMENTAL STUDIES ON DECORIN IN SUPPRESSION OF POSTOPERATIVE FLEXOR TENDON ADHESION IN RABBITS

目的探讨核心蛋白聚糖(decorin,DCN)抑制兔屈趾肌腱术后粘连的效果。方法日本大耳白兔18只,其后肢第2趾供实验用,将伸屈趾肌腱横断,作改良的Kessler缝合,不缝合腱鞘,右侧腱鞘内肌腱缝合位点直接注射DCN100μl(0.25mg/ml)作为实验趾;左侧直接注射PBS100μl作对照趾。术后2、4及8周取材,行大体观察、生物力学检测和组织学观察。结果大体观察,术后各时间点实验趾的粘连程度明显小于对照趾。生物力学检测显示各时间点实验趾肌腱滑移距离和关节总屈曲度明显大于对照趾,差异有统计学意义(P<0.05)。组织学观察见实验趾术后2周成纤维细胞增生不明显,4周增生明显,8周胶原纤维排列规则,直径大小均一;对照趾2周成纤维细胞增生,4周成纤维细胞增生减少,8周胶原纤维排列不规则,直径大小不一。结论核心蛋白聚糖能明显减少屈趾肌腱损伤的术后粘连,调节胶原纤维的形成,促进肌腱愈合。

Objective To study the effect of decorin in the suppression of postoperative flexor tendon adhesion. Methods Eighteen Japanese large ear white rabbits underwent complete transection of the Ⅱdigit flexor digitorum profundus tendon in zone Ⅱ and defects immediately were repaired using the modified Kessler technique with 5-0 nonabsorbable monofilament suture, The site of the right repaired tendon was then injected with 100 μl of decorin （0.25mg/ml） as test toe, the site of the left repaired tendon with 100 μl of PBS as control toe. In every group, rabbits were killed and the feet were prepared for biomechanical testing, macroscopic examination and histological inspection. Results In every group, biomechanical testing demonstrates that the sliding distances and the rangs of motion significantly increased in the test toe compared with the control toe（P〈0. 05）; macroscopic examination demonstrated that the tendon adhesions of the test toe were significantly reduced when compared with the control toe. In the tese toe, hematoxylin and eosin staining revealed that the hyperplasia of fibroblast was significantly delayed and the collagen fibrils arranged regularly and had the normal diameters. Conclusion Decorin can significantly reduce the flexor tendon adhesion formation, adjust collagen fibrillogenesis and promote the tendon healing.