FK506缓释膜片在异种神经移植修复周围神经缺损中的应用研究

An Experiment Study of Peripheral Nerve Regenration With Heterograft through Slow-releasing Diaphragm With the FK506

目的对大鼠坐骨神经缺损采用异种神经移植,并局部应用免疫抑制剂FK506聚乳酸膜片,观察其对神经再生的影响,以寻求一种促进周围神经再生的方法。方法制取FK506缓释膜片聚乳酸膜片后。选用健康6月龄W ister大鼠40只,雌雄不限,随机分为A、B两组,每组20只,显露坐骨神经,在坐骨神经分杈处向近端游离,造成1.2 cm的神经缺损后,给予以下处理:A组采用异种神经移植加空白聚乳酸膜片,B组采用异种神经移植加含免疫抑制剂FK506聚乳酸膜片。术后第4、8、12周分别对所有大鼠进行大体形态学观察、神经诱发电位及肌电图检查,并在第8周取神经进行乙酰胆碱脂酶染色及电镜观察。结果(1)4周时各组损伤侧均见腓肠肌萎缩,皆有足部溃疡及足趾坏死脱落现象,各组无明显差别,8周时溃疡面积减少,12周时B组溃疡有愈合,可见足趾活动;(2)神经肌电图:4周时各组无差异,8周时波幅恢复率:B>A,12周时差异更明显,两组之间统计学上有显著性差异。(3)光镜观察:各组均有神经再生现象,B组再生神经较多。(4)电镜观察:各组均有新生神经纤维,B组标本可见神经纤维再生多,较成熟,微丝、微管等结构正常较多。

Objective：To repair the rat sciatic nerve defect with heterograft and determine the effect of peripheral nerve regeneration through implanting slow - releasing diaphragm with FK506 around the nerve anastomosis in order to get a new method to promote peripheral nerve regeneration. Methods：After make slow - releasing diaphragm with FK506 ,40 adult Wistar rats were divide into A, B groups randomly . by radons. Each group has 20 rats. Exposing sciatic nerve and making 1. 2 cm nerve defect ,then give different treat：the group A was allograft and no FKS06 diaphragm, the group B was allograft and given K506 diaphragm. At 4 ,8,12th weeks post operation ,the morphological observation ,eleetrophisiology were determined ,and at 8th weeks post operation , Acetylcholinesterase staining and EMG were examined to sciatic nerve and HE staining was examined to kidney o Results ：（1）There were atrophic gastrocnemius muscle , trophic ulcer on toe and sole and necrosis of toe and no differences existed between comparisons of all in all groups at 4th weeks post operation . The trophic ulcer become to heal at 8th weeks post operation . At 12th weeks post operation part trophie ulcer of group B have healed, the toes of group B can move. （2）Electrophisiology ：there no different between each group at 4th weeks post operation. At 8th weeks post operation amplitude of nerve evoked potentials wave have improved , group B 〉 group A, there were more dif- ferent at 12th weeks post opcration（3）Light microscopic examination：Nerve regeneration was found in all groups. There were more regenerating nerve fibers in group B. （4） Electronic microscopic examination： There are regenerating nerve fibers in all groups , there are more maturitial regenerating nerve fibers and the structure of microfilament and microtubule is normal in group B ,group . Conclusion： Application of slow-, releasingdiaphragm of FK506 can promote reripheral nerve regeneration by heterograft at velocity and quality.