利用罗曼鸡肌腱滑液鞘体内构建趾深屈肌腱的生物力学及组织学研究

Biomechanical and histological research on in vivo engineered tendon with tendon synovial sheaths in Roman chicken

目的探索肌腱滑液鞘对肌腱体内再生的作用。方法将36只罗曼鸡随机平均分为A、B两组。A组把左趾深屈肌腱滑液鞘的上、下、右侧分离,不切断趾深屈肌腱。同种异体脱细胞肌腱用部分分离的腱滑液鞘包裹,并固定在趾深屈肌腱左侧。B组直接把同种异体脱细胞肌腱固定在去除肌腱滑液鞘的趾深屈肌腱左侧。另取右趾深屈肌腱作为正常对照组。分别在第4、8、12周取材进行趾深屈肌腱最大载荷、弹性模量的生物力学检测及HE染色的组织学检测。结果术后第4、8、12周时,除第4周A、B组在弹性模量方面差异无统计学意义,其余时间点A组最大载荷和弹性模量都大于B组(P<0.05)。随时间延长,A组胶原纤维增多,排列紧密,方向一致,炎性细胞浸润及纤维组织增生程度较轻。而B组胶原纤维数量逐渐减少、排列逐渐散乱,炎性细胞浸润、纤维组织增生程度明显高于A组。结论腱滑液鞘有助于肌腱再生,说明合适的体内环境对肌腱构建具有重要作用,本研究结果对临床上肌腱缺损病人找到合适肌腱替代物有积极作用。

Objective To explore the role of tendon synovial sheaths in tendon regeneration in vivo. Methods Thirty-six Roman chicken were randomly divided into Group A and B, with 18 chicken in each group. In Group A, the synovial sheaths of the deep flexor tendons in the left middle toes were separated from the up, right and down side without curing off the tendons themselves. The aUograft decellularized tendons were coated with synovial sheaths which were detached partly and fixed on the left side of the normal deep flexor tendons in the middle toes of the left foot. In Group B, the allograft decelluladzed tendons were directly implanted on the left side of the deep flexor tendons without coating of synovial sheaths. The normal deep flexor tendons from the right foot were used as the control group. The maximum loads and elastic modulus of the tendons at 4th, 8th and 12th week were obtained by mechanical testing, and HE staining was conducted to observe histological changes of the tendons. Re- suits The maximum load at 8th and 12th week and elastic modulus at 4th, 8th and 12th week in Groups A were greater than those in Group B, with significant differences （P 〈0.05）. Group A showed more densely deposited matrices and longitudinally aligned collagen fibers than Group B, and inflammatory cells and fibrous tissues could hardly be found in Group A. In Group B, the collagen fibers were decreased gradually, with disordered align- ment. Furthermore, more inflammatory cells infiltration and hyperplasia of fibrous tissues were found in Group B. Conclusions The synovial sheaths can contribute to tendon regeneration, indicating that a proper environment in vivo plays an important role in the engineered tendons. This study has a positive effect on finding proper tendon replacements for patients with tendon deficiency.