改性壳聚糖防粘连膜修复坐骨神经损伤

Rat sciatic nerve injury treated with anti-adhesion membranes of modified chitosan

背景:研究表明壳聚糖与动物及人体具有较好的生物相容性、可降解性,可支持许旺细胞在壳聚糖膜上生长,而且能够明显抑制成纤维细胞生长。目的:观察改性壳聚糖防粘连膜对大鼠坐骨神经再生修复的影响。方法:切断60只SD大鼠双侧坐骨神经,缝合外膜,随机在一侧坐骨神经缝合处包裹改性壳聚糖防粘连膜,以另一侧为对照。术后20,30,40d进行电生理及组织学检测,观察改性壳聚糖防粘连膜对大鼠坐骨神经损伤修复的影响。结果与结论:早期改性壳聚糖防粘连膜治疗侧神经断端的炎性反应较对照侧明显,随着膜的自行降解,炎症反应逐渐减轻,神经缝合口纤维组织增生减少。与对照侧相比,大鼠坐骨神经损伤30d后,改性壳聚糖防粘连膜治疗侧神经传导速度恢复快,比目鱼肌记录到的神经-肌肉电潜伏期缩短(P<0.05)。30d后各时点与对照侧比较,改性壳聚糖防粘连膜治疗侧坐骨神经再生轴索密度大于对照侧(P<0.05)。说明改性壳聚糖防粘连膜虽早期会加重周围神经损伤的炎性反应,但随着膜的降解,炎症反应逐渐减轻,可减轻神经缝合口纤维组织增生,防止粘连,因而有利于神经传导速度恢复及轴索生长。

BACKGROUND：Chitosan has good biocompatibility and biodegradability with animals and human bodies,it can support Schwann cell grow on chitosan membranes and markedly inhibit fibroblast growth.OBJECTIVE：To observe the effect of modified chitosan anti-adhesion membranes on sciatic nerve regeneration in rats.METHODS：Bilateral sciatic nerve was cut off in 60 SD rats,and the outer membrane was sutured.The suture of unilateral sciatic nerve was randomly packaged with modified chitosan anti-adhesion membrane,while the contralateral suture served as the controls.At 20,30,40 days post-operation,the electrophysiology and histological detections were performed,to observe the effect of modified chitosan anti-adhesion isolated membrane on sciatic nerve regeneration of rats.RESULTS AND CONCLUSION：Compared with the controlled suture,the modified chitosan anti-adhesion membranes aggravated the inflammatory response of nerve stumps.With the degradation of the membranes,inflammation relieved gradually,fiber hyperplasia of nerve tissue was relieved.At 30 days after sciatic nerve injury,the speed of conduction velocity of regenerated nerve was faster at the treated side,the nerve-muscle latency recorded by soleus muscle was shortened （P 0.05）.The density of nerve regenerated axons was significantly greater in the modified chitosan anti-adhesion membrane group than in the control group at every point after 30 days of injury.Although modified chitosan anti-adhesion membrane aggravate the inflammatory response of peripheral nerve injury in early stage,with the degradation of the membranes,inflammation relieves gradually.It could relieve fiber hyperplasia of nerve tissue and prevent adhesion,and it can improve recovery of conduction velocity and regeneration of nerve axon.