组织工程化肌腱修复运动训练致肌腱组织缺损:细胞材料及其过程中的相关研究

Tissue-engineered tendon repairing tendon tissue defect induced by movement training:A correlated research of cell materials

背景:传统的肌腱修复方法主要采用自体肌腱移植和自体肌腱转移方法修复,但这两种方法因供区有限及新增的创伤制约,发展受到很大限制。目的:总结肌腱组织缺损修复中的种子细胞、支架及生物反应器中的生物力学刺激相关研究,为训练、竞赛中肌腱损伤的防治提供理论依据。方法:以"运动训练,肌腱组织,修复"为检索词,检索维普数据库2004-01/2009-10相关研究。纳入与运动训练所造成的肌腱组织损伤的研究;排除重复研究或Meta分析类文章。结果与结论:目前组织工程化肌腱的研究已经取得了显著的成果,但要真正应用于临床,大批量生产,仍存在一些问题。种子细胞的来源不能仅限于自体肌腱细胞,对皮肤成纤维细胞及肌腱细胞进行比较,通过基因芯片等方法,了解二者的区别,对成纤维细胞进行基因改造,以此解决组织工程肌腱的种子细胞来源问题。肌腱再生过程中正常的力学刺激对新生肌腱的塑形至关重要,这种刺激才可能诱导新生胶原纤维并取向排列。进而提高新生肌腱的力学强度,保证早期功能锻炼的实施,有效减少肌腱黏连。使肌腱的修复过程步入一个良性循环寻找理想的支架。所以,教练员、运动员在运动训练、竞赛中,应该遵守训练学原则,进行科学训练,尽量避免肌腱组织缺损。尽管肌腱组织工程发展得很好,但它还会给身心一些不良影响。

BACKGROUND：Traditionally,tendon was repaired by autoallergic tendon transplantation and transfusion;however,both methods were limited by supply region and additional trauma,and the development was slowed down.OBJECTIVE：To summarize biomechanical characteristics of seed cells,stent,and bioreactor during repairing tendon tissue defect,and provide prevention and cure of tendon injury induced by training and competition.METHODS：A computer-based online search was conducted in VIP database with the keywords of＂movement training,tendon tissue,repair＂from January 2004 to October 2009.Articles which were related to tendon tissue injury induced by movement training were included,but articles related to duplicated research or Meta analysis were excluded.RESULTS AND CONCLUSION：Tissue-engineered tendon has achieved therapeutic effects to a certain degree;however,it is still not used for clinical application.Source of seed cells was restrict to autoallergic tendon cells;on the other hand,comparison between fibroblast and tendon cells,gene chip was used to modify gene in order to solve source of seed cells of tissue-engineered tendon.During regeneration of tendon,normal mechanical stimulation played an important role in moulding of newborn tendon.Because the stimulation might induce orientation arrangement of newborn collagen fiber,enhance mechanical strength of newborn tendon,make sure the functional training as early as possibly,effectively reduce tendon adhesion,and provide an ideal stent for great circulation of tendon repairing.Scientific training is necessary for coaches and athletes to avoid from tendon tissue injury during movement training and competition.Although tendon tissue engineering has developed well,it still brings adverse effect on body and mind.