肌腱的生物学特性及缺损后修复材料的性能评价

Biological characteristics of tendon and performance evaluation of repair materials for tendon defects

目的:探讨肌腱的生物学特性及肌腱缺损修复材料的性能。方法:用计算机检索中国期刊全文数据库(CNKI:1985/2009)和Medline database(1985/2009),纳入主题内容与肌腱生物学特性和肌腱缺损修复材料联系紧密的文章;排除Meta分析、与主题无关的文章及重复性研究。对文献进行筛选、资料收集和质量评价,共纳入29篇文章,其中中文文献16篇,英文文献13篇。从肌腱的生物学特性及肌腱缺损修复材料的性能进行总结。结果:肌腱的营养主要由肌腱当中的血管通过血液供给,肌腱在重复性载荷下会发生疲劳,但和其他工程材料不同之处在于肌腱具有自我修复能力;肌腱的生物力学特性与胶原纤维密切相关,应力应变曲线与胶原纤维基本相同,表现出明显的黏弹性体特性——滞后、蠕变和应力松弛。当前对肌腱缺损的修复材料主要有自体肌腱、同种异体肌腱、异种肌腱、人工肌腱替代物及组织工程化人工肌腱。结论:虽然肌腱缺损的修复材料较多,但是均具有其优缺点,目前仍未找到一种最理想的修复方法。目前对肌健的研究已进入分子水平,相信在不久的将来,组织工程和基因工程将制造出理想的肌腱替代品。

OBJECTIVE：To explore the biological characteristics of tendon and performance of repair materials for tendon defects.METHODS：CNKI and Medline database were retrieved by computer for papers published between 1985 and 2009.Literature concerning biological characteristics and performance of repair materials for tendon defects were selected.Meta analysis,irrespective papers or repetitiveness studies were excluded.Totally 29 papers were included after screening and evaluating including 16 in Chinese and 13 in English.The biological characteristics of tendon and performance of repair materials were summarized.RESULTS：Nutrition for tendon mainly supplied by blood,and the tendon fatigue would be occurred with repeatability loads.Compared to other tissue-engineered materials,tendon possesses self-repair ability.The biological characteristics of tendon was closely associated with collagen fiber,which exhibited similar stress-strain curves,namely,characteristics of viscoelasticity body—hysteresis,creep and stress relaxation.Currently,main repair materials for tendon defects comprised autogenous tendons,allogeneic tendon,artificial tendon and tissue engineered tendon.CONCLUSION：Many materials can be used in tendon repair with distinct advantage and disadvantage;however,there is not an ideal repair method.With the development of tissue and gene engineering,the optimal substitute for tendon would be prepared.