三七凝胶对硬膜外黏连TIMP-1、MMP-1的影响

Influence of Sanchi gel on TIMP-1 and MMP-1 expression in epidural adhesion

目的探讨三七凝胶对椎板切除术后硬膜外黏连基质金属蛋白酶-1（MMP-1）、基质金属蛋白酶抑制剂-1（TIMP-1）表达的影响。方法建立椎极切除术模型，将72只大鼠按随机数字表法分为生理盐水组、黏连平组、凝胶组和三七凝胶组，各18只，分别在术后第7、14、21天采用免疫组化进行动态观察，分析愈合过程中TIMP-1和MMP—1的表达。结果不同处理方法对TIMP—1、MMP-1的影响作用不同，作用强度存在差异。术后14d、21d时TIMP-1的表达逐渐增强，但阳性细胞数逐渐减少，三七凝胶细的TIMP-1表达均弱于其他三组（P均〈0．05）；术后14d各细MMP-1的表达开始增强，但无明显差异（P〉0．05）；术后21d三七凝胶组MMP—1的表达强于其他三组（P〈0．05），各组中MMP-1的阳性细胞数随时间的延长逐渐减少。结论三七凝胶预防硬膜外黏连的作用可能与调控TIMP-1和MMP-1的表达有关。

Objective To explore the effects of Sanchi gel on MMP-1 and TIMP-1 expression in epidural adhesion after laminectomy. Methods Laminectomy model was set up in SD rats. 72 SD model rats were divided randomly into Saline group, Zhanlp group, Carbopol Gel group and Sanchi Gel group, with 18 rats in each group. On 7, 14 and 21 days after the laminectomy, immunohistochemistry （method of S-P） was adopted to detect the expression of TIMP-1 and MMP-1. Results Different treatments had different influence on TIMP-1 and MMP-1 expression in epidural adhesion. The expression of TIMP-1 increased gradually on 14 d and 21 d after operation, and Sanqi Gel group showed weaker expression than the other groups （P〈0.05）, but the number of positive cells decreased gradually. As to the expression of MMP-1, there was no difference among each group at the end of the second week （P〉0.05）. There was a difference between Sanchi Gel group and the other groups at the end of third week （21 d） （P〈0.05） after operation. Sanchi Gel group showed higher expression of TIMP-1 than the other groups.The number of positive cells sharply decreased from 14 d to 21 d after operation. Conclusion Sanchi Gel has a significant preventive effect on fibrous scar formation after laminectomy. The possible mechanism of preventing epidural adhesion after laminectomy by Sanchi Gel could be its regulating and controlling the expression of TIMP-1 and MMP-1 in epidural tissue.