纤维蛋白凝胶携载血管内皮生长因子对大鼠损伤坐骨神经运动功能的影响

Effect of fibrin glue loaded exogenous vascular endothelial growth factor on the motor function of rats with sciatic nerve injury

背景:坐骨神经损伤后的修复方法多样,但由于坐骨神经解剖和功能上的特殊性,神经功能的恢复仍不理想。目的:观察局部应用纤维蛋白凝胶携载血管内皮生长因子,对损伤坐骨神经组织神经功能恢复的疗效。方法:将Wistar大鼠左侧坐骨神经切断,神经两断端原位缝合,制作大鼠坐骨神经损伤动物模型,然后随机分为2组,实验组于坐骨神经切断处外膜内、外注射纤维蛋白凝胶/血管内皮生长因子复合体;对照组于同处注射血管内皮生长因子165质粒。于用药后4,8,12周行大体观察、神经功能指数检测、电生理检测(测运动神经传导速度)。结果与结论:两组动物伤口均为一期愈合。实验组用药后1周有6只出现足底溃疡伴肌萎缩;对照组有5只出现足底溃疡。实验组4周时,纤维蛋白凝胶基本被吸收;8周时完全吸收;12周时,神经外形基本正常。对照组4周时,神经轻度充血、水肿;8周时,神经无水肿,与周围组织见少量粘连;12周时,神经周围见瘢痕形成。实验组4,8周的神经功能指数、运动神经传导速度较对照组降低(P<0.05),12周无显著性差异(P>0.05)。提示纤维蛋白凝胶可以作为血管内皮生长因子的载体,纤维蛋白凝胶携载血管内皮生长因子给药可以促进损伤神经结构和功能的恢复。

BACKGROUND：There are various methods for repair sciatic nerve injury,however,the recovery of nerve function is not satisfactory due to complexity of sciatic nerve anatomy and function.OBJECTIVE：To investigate the effects on functional outcome of the injured sciatic nerve using exogenous vascular endothelial growth factor（VEGF）mixed with fibrin glue as a carrier.METHODS：The sciatic nerve injury model was made by cutting off the left sciatic nerve of Wistar rats and suturing in normal position.The successful model rats were randomly into two groups.Experimental group was injected with VEGF/fibrin glue complex via adventitia at the site of cutting off sciatic nerve.Control group was injected with VEGF165 plasmid.Sciatic-nerve function index,motor nerve conduction velocity and gross appearance were performed at 4,8,12 weeks after medication.RESULTS AND CONCLUSION：The primary healing of wound was found in animals of two groups.At 1 week after treatment,6 rats of the experimental group appeared foot ulcers and muscle atrophy;five rats of the control group showed foot ulcers.In the experimental group,fibrin gel almost absorbed at 4 weeks,completely absorbed at 8 weeks,normal nerve appearance was found at 12 weeks.In the control group,nerve showed mild congestion and edema at 4 weeks,the edema disappeared and the nerve slightly adhered on surrounding tissues at 8 weeks,the scars formed surrounding nerves at 12 weeks.At 4 and 8 weeks in the experimental group,nerve function index and nerve conduction velocity were lower than the control group（P〈0.05）,with no statistical difference at 12 weeks（P〈0.05）.These results indicate that fibrin glue can be used as a carrier for VEGF,fibrin glue carrying VEGF can enhance neurological structural and functional recovery of the injured nerve.