自体成肌细胞甲杓肌注射治疗创伤性声门关闭不全的实验研究

The Effects of Autologous Skeletal Myoblasts Transplantation on Hurted Vocal Cord of Paralysis

目的观察自体成肌细胞甲杓肌注射对创伤性声门关闭不全的疗效。方法将20只成年新西兰大白兔行左侧喉返神经切断并于左侧声带表面划痕(深度超过上皮层到声带肌),建立左侧喉返神经切断、左侧声带创伤后声带疤痕形成的创伤性声门关闭不全的动物模型;同时,分离这20只大白兔胸锁乳突肌成肌细胞,进行体外培养、分离及扩增。12周后,将20只动物随机分为A、B两组,每组10只,A组(成肌细胞注射组)于左侧声带甲杓肌注射成肌细胞0.3ml时,右侧声带不作任何处理作为正常对照;B组(盐水注射对照组)于左侧声带甲杓肌注射等量生理盐水,右侧声带不作任何处理作为正常对照,12周后分别观察两组动物双侧甲杓肌肌纤维直径和声带体积。结果 A组自体成肌细胞左侧甲杓肌注射12周后双侧甲杓肌肌纤维直径及声带容积大小差异无显著统计学意义(P>0.05),B组注射侧甲杓肌肌纤维直径及声带体积明显小于A组(P<0.05)。结论经甲杓肌注射自体成肌细胞能有效地治疗创伤性声门关闭不全。

Objective The goal of the present experimental study is to investigate effects on the injection of a- dult rabbit autologous skeletal myoblasts into the thyroarytenoid（TA） muscle after recurrent laryngeal nerve （RLN） damage and traumatic vocal cords. Methods 20 adult New Zealand white rabbits were used for the establishment of an animal model simulating the cut--off of the left recurrent laryngeal nerve and the left vocal cord trauma scar for- mation after traumatic damage. Then from the rabbits, the sternocleidomastoid muscle cells were cultured, separa- ted and expanded. After 12 weeks, the 20 animals were randomly divided into group A, group B with 10 in each group. Group A（myoblast injection group） in the left vocal cord thyroarytenoid muscle injection of myoblasts 0.3 ml, the right vocal cord without any treatment served as normal controls; Group B（saline injection control group） in the left vocal cord thyroarytenoid muscle was injected with normal saline, the right vocal cord without any treatment as normal controls, respectively, were observed after 12 weeks of bilateral thyroarytenoid muscle fiber diameters and vocal cord volumes. Results After 12 weeks, Group A＇s left thyroarytenoid muscle injection of bilateral thyroaryten- oid muscle fiber diameter and the vocal volume size was not significantly different （P〉0.05）, thyroarytenoid muscle fiber diameter and the vocal cord volume on Group B＇s injected side was significantly smaller than Group A（P〈 0.05）. Conclusion The thyroarytenoid muscle injection of autologous myoblasts can effectively treat recurrent la- ryngeal nerve （RLN） injury and traumatic vocal cords.