脱细胞神经基质膜在大鼠坐骨神经损伤修复中作用的实验研究

Experimental study of a decellularized nerve matrix membrane in the repair of sciatic nerve injury in rats

目的研究脱细胞神经基质膜用于周围神经修复时的有效性。方法使用SD大鼠坐骨神经修复模型进行研究,实验组使用脱细胞神经基质膜包裹修复的坐骨神经,对照组则不使用膜进行包裹。术后2、4、8、12和20周对手术肢体足底溃疡情况进行观察,并进行针刺展爪反应实验。术后20周对坐骨神经指数进行测算,对手术肢体的坐骨神经进行神经电生理测量,对神经缝合口粘连情况进行观察,对神经缝合口远、近端神经组织切片进行病理学研究。结果实验组"坏足强度"、坐骨神经功能指数、神经传导速度等结果均优于对照组(P<0.05)。实验组神经缝合口粘连程度明显轻于对照组。神经缝合口远、近端神经横切面的HE染色和甲苯胺蓝染色,S-100蛋白、MBP蛋白和NEFH蛋白免疫组化染色结果显示实验组坐骨神经轴突再生优于对照组。结论在大鼠模型中,使用脱细胞神经基质膜包裹损伤的坐骨神经能有效阻止周围的结缔组织侵入神经缝合处,降低神经与周围组织的粘连程度,促进神经再生。

Objective To study the efficacy of a decellularized nerve matrix membrane in peripheral nerve repair.Methods The sciatic nerve repairing model of Sprague-Dawley rats was used in this study.The repaired sciatic nerves were wrapped with the decellularized nerve matrix membrane in the experimental group,while without the membrane in the control group.The plantar ulcers of the operated limbs were observed,and the claw-spread reflex analysis were recorded at 2,4,8,12 and 20 weeks after operation.The sciatic functional index was measured,neuro-electrophysiological examination was performed,tissue adhesion of the anastomosis site was evaluated,and the pathological study of the distal and proximal segments to the nerve anastomosis site was carried out at 20 weeks after operation.Results The intensity of hind claw dysfunction,the sciatic functional index,and the nerve conduction velocity of the rats in the experimental group were superior to those in the control group.The degree of anastomotic adhesion of the rats in the experimental group were significantly lighter than that in the control group.The results of the HE staining and toluidine blue staining,immunohistochemical staining of S-100,MBP,and NEFH protein showed that the experimental group was better than the control group.Conclusion The wrapping nerve anastomosis site with a decellularized nerve matrix membrane could effectively prevent surrounding tissues from invading the anastomosis site,reduce tissue adhesion,and enhance nerve regeneration in rat sciatic nerve transection model.