脊髓损伤两种修复方法的比较研究

A comparison study between two models of repairing on spinal cord injury

目的 :比较脊髓损伤后两种修复方法的效果。方法 :损伤成鼠胸髓左后柱 ,移植孕 1 4d胚胎脊髓 (F组 ) ,胚胎脊髓加自体带蒂正中神经 (V +F组 )及不移植 (对照组 ) ,观察胚胎脊髓的生长、分化情况及对宿主的修复能力。结果 :V +F组胚胎脊髓体积增长速度、神经纤维数量和神经元密度显著高于F组 (P <0 0 1 ) ,细胞分化较好 ,突触较成熟 ,界面区无明显的胶质增生。V +F组SEP的P1、N1波潜伏期显著缩短 (P <0 0 1 )。结论 :联合移植比单纯胚胎脊髓移植更有利于脊髓损伤的修复。

Objective:To compare the repairing effect between two experimental models.Method: A 5mm cord defect of the left lateral column was made at T1～T3 vertebral level, and then the defect was grafted using embryonic day 14 fetal spinal cord (Group F), vascularized peripheral nerve and fetal spinal cord (Group V+F) respectively. The survival and differentiation of the grafts and the ability of repairing host spinal cord were assessed.Result:8 weeks after surgery, the fetal implant was intimately fused with the host CNS parenchyma, few glial scar partition were present,the volume,nerve fiber number and neurons density of the fetal implant were significantly higher than Group F ( P <0 01).The majority of neurons in fetal spinal cord were well differentiated, including well developed synapses, exhibited a high level of maturity.SEP assessments showed that the latency of P 1, N 1 wave was significantly decreased in this group( P <0 01).Conclusion:The model in which vascularized peripheral nerve co grated with fetal spinal cord could prompt the survival and development of fetal implant, support the regeneration of central injured axons, and the effect excels simply fetal spinal cord graft. Author′s address Department of Orthopedics, Daping Hospital,The Third Military Medical University,Chongqing,400042