NTN/PGLA导管修复兔面神经缺损与自体神经移植修复的比较

A comparative study of nerve autograft and PGLA tube containing neuturin: the observation of neuron changes

目的研究面神经低位切断伤后,应用重组NTN(Neurtuin)神经营养因子/PGLA(polygly co-lacticacid,聚乙交酯-丙交酯)导管修复术后,面神经核内神经元的变化,并与自体神经移植修复相比较。方法制作新西兰兔左侧面神经低位切断伤+自体神经修复模型,右侧低位切断伤+NTN/PGLA导管修复模型,运用辣根过氧化物酶(horseradish peroxidase,HRP)逆行追踪标记,对标记神经元的分布和数量进行定性,定量观察。结果(1)HRP逆行追踪NTN/PGLA导管侧于术后10周成功标记到FMN,提示可恢复神经缺损段的轴浆流逆行运输,且两侧标记的细胞数无显著性差异(P>0.05)。(2)术后14周自体神经移植侧标记细胞均出现分布异位,而NTN/PGLA导管侧仅1例出现,标记细胞发生异位分布的概率明显少于自体神经移植侧(P<0.01)。结论应用NTN/PGLA导管的修复能够和自体神经移植修复一样恢复神经缺损的连续性和逆行轴浆运输功能,后期效果相当;应用NTN/PGLA导管修复后神经元分布异位明显少于自体神经移植修复,提示较少发生轴突误向再生,减少面肌联带运动的发生。

Objective To elucidate the effects of the repair of facial nerve with PGLA tube containing Neurturin（NTN）, and observe the changes of the neurons, then to compare the changes with nerve autograft. Method The animal models were made, left facial nerve of 24 New Zealand bucks, performed as distal transection and PGLA tubes containing NTN were implanted, right facial nerve acted as distal transection and nerve autograft, horseradish peroxidase（HRP） retrograde mark method was used, we observed the distribution of facial motoneurons quantitatively and qualitatively. Result （1） HRP labelled neurons were found in the NTN/PGLA group in the 10th week after injury, indicating the axoplasm flow of regenerated nerve fiber was recovered. The number of the labelled neurons has no significant difference between the NTN/PGLA group and the autograft group. （2） 14th week after injury, the reorganization of labelled neurons＇ distribution was found in the autograft group, but only one case in the NTN/PGLA group. Conclusion Local application of PGLA tube with neurturin can recover the axoplasm flow of regenerated nerve fibers, its long-term effect can match that of the nerve autograft, and collateral axonal branching occurred less.