VEGF复合透明质酸钠对异体BPTB重建兔前交叉韧带再血管化的影响

Influence of VEGF composite with sodium hyaluronate on graft re-angiogenesis in anterior cruciate ligament reconstruction using BPTB allograft in rabbits

目的研究血管内皮生长因子(VEGF)复合透明质酸钠(SH)对异体骨-髌腱-骨(BPTB)重建兔前交叉韧带(ACL)再血管化的影响,为提高肌腱移植物愈合质量提供一种新方法。方法将24只成年新西兰大白兔随机分为A、B两组,每组12只24膝。A组随机选择兔双膝中的一侧植入经VEGF和SH复合处理后的BPTB(SH-VEGF组),另一侧植入仅由PBS处理的BPTB(空白对照组);B组同法选择一侧植入经VEGF处理的BPTB(VEGF组),另一侧植入经SH处理的BPTB(SH组)。A、B两组术后2、4、8周分别处死4只实验动物,对移植物进行大体形态学观察,采用苏木精-伊红染色和免疫组化法评估移植物再血管化情况。结果2、4、8周SH-VEGF组和VEGF组肌腱移植物血管化程度大于SH组和空白对照组,差异有统计学意义(P<0.05);SH-VEGF组和VEGF组间差异也有统计学意义(P<0.05)。结论在兔ACL异体BPTB重建过程中,SH可作为VEGF的良好载体;SH和VEGF复合后更能促进肌腱移植物早期再血管化。

Objective To explore the influence of vascular endothelial growth factor(VEGF)composite with sodium hyaluronate(SH)on graft re-angiogenesis in anterior cruciate ligament(ACL)reconstruction using bone-patellar tendon-bone(BPTB)allograft in rabbits,so as to provide a novel method for improving healing quality of tendon graft.Methods Twenty-four New Zealand rabbits were randomly divided into group A and group B(12 rabbits,24 knees in each group).In group A,rabbits which one side of knees randomly implanted BPTB allograft with composite of VEGF and SH were divided into SH-VEGF group,while in blank control group,BPTB treated by PBS were implanted into another side of knees in rabbits.In group B,rabbits which one side of knees randomly implanted BPTB allograft treated by VEGF were divided into VEGF group,while in SH group,BPTB treated by SH were implanted into another side of knees in rabbits.In group A and group B,every 4 rabbits were sacrificed respectively at 2,4,8 weeks after operation,gross morphology of grafts was observed,and graft reangiogenesis was evaluated by HE staining and immunohistochemistry method.Results At 2,4 and 8 weeks after the operation,degree of graft reangiogenesis in SH-VEGF group and VEGF group was better than that in SH group or blank control group(P<0.05).At the same time,difference between SH-VEGF group and VEGF group showed statistical significance(P<0.05).Conclusions During ACL reconstruction with BPTB allograft in rabbits,SH can be used as a good carrier of VEGF;VEGF composite with SH can improve the early re-angiogenesis of tendon graft.