碱性成纤维细胞生长因子对大鼠肩袖损伤术后冈上肌腱生物力学的影响

Biomechanics effect of basic fibroblast growth factor on supraspinatus tendon of rats following surgery for rotator cuff tears

目的评价碱性成纤维细胞生长因子(BFGF)对大鼠肩袖损伤重建术后腱-骨界面愈合的修复效果。方法 135只Wistar大鼠分为高剂量组、低剂量组和空白组各45只,取右侧肩袖大结节止点处横断撕裂肩袖冈上肌腱全层,6周后原位缝合,腱骨界面注射以纤维蛋白胶为载体的BFGF。缝合术后1、2、3周,每次处死各组15只大鼠,取右上肢冈上肌腱标本行腱-骨界面最大载荷百分比、刚度及刚度百分比生物力学测试。结果在术后1、2及3周,高剂量组及低剂量组的冈上肌腱术侧/健侧最大载荷百分比均高于空白组(P<0.05);在术后2周及3周,高剂量组的冈上肌腱术侧/健侧最大载荷百分比高于低剂量组(P<0.05)。术后2周及3周,高剂量组的刚度均高于低剂量组及空白组(P<0.05);术后1周及2周,高剂量组/空白组与低剂量组/空白组的刚度百分比均高于高剂量组/低剂量组(P<0.05)。结论 BFGF可提高腱-骨界面的最大载荷百分比、刚度,诱导断面再生成直接止点的复杂结构促进肩袖损伤的愈合。

Objective To evaluate the repairing effect of basic fibroblast growth factor（ BFGF） on tendon-bone healing of rats following the reconstruction for rotator cuff tears. Methods A total of 135 Wistar rats were divided into high-dose group,low-dose group and blank group,with 45 rats in each group. The full-thickness supraspinatus tendon was transversely torn at the insertion of greater tuberosity of right lateral rotator cuff,suture in situ was performed six weeks later,and BFGF with fibrin sealant as a carrier was applied to tendon-bone injection. Fifteen rats in each group were sacrificed per time in the first,second and third week after suture,respectively. The supraspinatus tendon samples of right upper extremity were collected for the biomechanics test of maximum loading percentage,stiffness and percentage of stiffness of tendon-bone junction. Results The maximum loading percentages of contralateral to ipsilateral supraspinatus tendon of high-and low-dose groups were all significantly higher than those of blank group in the first,second and third week after operation（ P 〈 0. 05）. The maximum loading percentages of contralateral to ipsilateral supraspinatus tendon of high-dose group were significantly higher than those of low-dose group in the second and third week after operation（ P 〈 0. 05）. The stiffness of high-dose group was significantly higher than that of low-dose group or blank group in the second and third week after operation（ P 〈 0. 05）. The percentages of stiffness of high-dose group to blank group and low-dose group to blank group were significantly higher than that of high-dose group to low-dose group in the first and second week after operation（ P 〈 0. 05）. Conclusion BFGF might increase the maximum loading percentage and stiffness of tendon-bone junction,transversely regenerate the direct insertion of complex structure,and promote the healing of rotator cuff tears.