四甲基吡嗪对硬膜外疤痕粘连形成及疤痕中bFGF和α-SMA表达的影响

Experiment study on the impact of TMP on expression of bFGF and α-SMA in formation of epidural scar adhesion

目的研究四甲基吡嗪(tetraethy lhydrazine,TMP)对硬膜外疤痕粘连形成及疤痕中的碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)和α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)表达的影响,从分子角度探讨TMP防治硬膜外疤痕粘连的机制。方法30只新西兰兔,采用非相邻三椎板(L2、L4、L6)切除模型,三个椎板缺损分别随机置入生理盐水、透明质酸钠及TMP,2、4、8周时各处死10只,观察椎板缺损处的硬膜外疤痕粘连情况,免疫组化测定疤痕中bFGF和α—SMA的表达。结果TMP组硬膜外疤痕粘连等级和疤痕中bFGF、α-SMA的表达在2、4、8周时均低于生理盐水组(均P<0.05),2、4周时与透明质酸钠组差异无显著性(均P>0.05),8周时低于透明质酸钠组(均P<0.05),且疤痕粘连等级与bFGF、α-SMA的表达呈正相关(P<0.05)。结论局部使用TMP后能抑制椎板切除术后的硬膜外疤痕粘连形成,晚期疗效优于透明质酸钠。TMP可能通过降低bFGF的表达,从而抑制硬膜外疤痕粘连形成。疤痕中的α-SMA表达能较好地反应硬膜外疤痕增生和收缩程度。

[Objective] To observe the grade of adherence and the expression of bFGF and α-SMA in formation of epidural scar adhesion by using TMP （Tetramethyl Pyrazine） locally. [Methods] 30 healthy adult New Zealand rabbits were used, laminectomies were performed in every rabbit at L2, L4 and L6. The three defeats respectively and randomly were filled with NS, sodium hyaluronate and TMP. Every 10 rabbits were. sacrificed at 2, 4, 8 weeks postoperatively. All specimens were evaluated grossly and studied with immunohistochemistry. [Result] More epidural scar adhesion and higher positive expression of bFGF and α-SMA were observed in group Of NS and 8 week＇s sodium hyaluronate group, little scar adhesion and lower positive expression of bFGF and α-SMA was observed in group of TMP （P 〈0.05）. The severity of epidural scar adhesion positively correlated with the expression of bFCF and α-SMA. [Conclusion] TMP can relieve epidural scar adhesion and inhibit the expression of bFGF and α-SMA, so it is useful for prevention of epidural scar adhesion after lamineetomy.