应用几丁糖-胶原-复方倍他米松缓释凝胶促进周围神经再生实验研究

Chitosan-collagen compound betamethasone gel enhanced peripheral nerval regeneration in rats

目的评价修复周围神经损伤后,神经吻合口局部应用几丁糖-胶原-复方倍他米松缓释凝胶抑制瘢痕组织增生、促进神经再生的效果。方法 45只成年雄性SD大鼠切断右侧胫神经后采用神经外膜缝合法进行修复,然后随机为3组:单纯神经缝合组,单纯缝合+几丁糖-胶原组,单纯缝合+几丁糖-胶原-复方倍他米松组,每组15只。分别于术后4,8,12周行大体观察和神经电生理检查,术后12周行组织学检测和计算机图像分析。结果单纯缝合+几丁糖-胶原-复方倍他米松组大鼠神经吻合口局部瘢痕组织增生和粘连程度较其他两组明显减轻,再生神经纤维较直,排列结构较整齐;12周时电生理检查示复合肌肉动作电位波幅最大[(6.2±2.1)mV],图像分析示远端神经轴突平均直径最长[(3.40±0.28)μm],有髓神经纤维再生率最高(95%±4%),与其他两组比较差异均有统计学意义(均P<0.05)。结论几丁糖-胶原-复方倍他米松凝胶能有效防止周围神经损伤修复后局部瘢痕组织增生和粘连,促进神经再生和功能恢复。

Objective To investigate the preventive effect of chitolsan-collagen compound betamethasone gel on scar formation and nerval regeneration following peripheral nerval injuries. Methods The right tibial nerves of 45 SD rats were transected and immediately repaired, and then the rats operated were randomly divided into 3 groups： control group, treated with chitolsan-collagen gel group, and treated with chitolsan-collagen compound betamethasone gel group （n = 15 in each group）. At 4, 8 and 12 weeks after surgical procedures, general observation, electrophysiological study and immunological labeling were performed. Results Compared with the control rats and ones treated with chitolsan-collagen gel, the rats treated with chitolsan-collagen compound betamethasone gel had less scarring formation and remarkably higher compound muscle action potential [ （6.2 ± 2.1 ） mV ], the longest fiber diameter [ （3.40 ± 0.28 ） μm ] and the highest fiber regeneration rate （95% ± 4%, all P 〈 0.05）. Immunological labeling showed that neuronal fibers were lined orderly in the compound betamethasone group. Conclusion Chitolsan-collagen compound betamethasone gel was effective in reducing scar formation and enhancing peripheral nerval regeneration.