神经生长因子与睫状神经营养因子影响周围神经再生的比较研究  

Effect of nerve growth factor and ciliary neurotrophic factor on peripheral nerve regeneration: comparative study

作　　者：李强[1] 李民[1] 伍亚民[1] 陈恒胜[1] 刘媛[1] 曾琳[1] 李应玉[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经损伤与修复研究室

出　　处：《中华手外科杂志》2004年第3期189-191,共3页Chinese Journal of Hand Surgery

基　　金：国家重大基础研究发展规划 (973)基金资助项目(G1 9990 542 0 6)

摘　　要：目的　比较神经生长因子 (nervegrowthfactor ,NEF)和睫状神经营养因子 (ciliaryneurotrophicfactor ,CNTF)促进大鼠坐骨神经再生作用的差异性。方法　用梭形双通道乳胶管桥接 3 2只SD大鼠坐骨神经缺损 (长 10mm)。按注入桥接管内物质的不同 ,将大鼠随机分为 2组。A组 :医用几丁糖凝胶组 (双侧 ) ,B组 :医用几丁糖凝胶 +NGF(左侧 )和医用几丁糖凝胶 +CNTF(右侧 )组。术后 12、16周对再生神经作肌电检测和形态学观察。结果　术后 16周 ,A组双支管内再生神经的形态无显著差异 (P >0 .0 5 )。B组NGF侧再生纤维排列欠整齐 ,以有髓纤维为主 ,且髓鞘厚 ,轴突直径大 ;CNTF侧再生神经纤维排列整齐 ,分布均匀 ,有髓纤维与无髓纤维均增加。NGF侧再生神经的运动传导速度慢于CNTF侧 ,但复合运动动作电位 (compoundmotoractionpotential,CMAP)和皮层体感诱发电位 (cortexsomatosesensoryevokedpotential,CSEP)的潜伏期较CNTF侧长 ,波幅较低 (P <0 .0 5 )。结论　NGF促进有髓纤维再生和髓鞘形成的作用较强 ,CNTF可同时促进有髓纤维和无髓纤维再生 ,且其促进神经功能恢复的作用优于NGF。Objective To compare the different effect of nerve growth factor (NGF)or ciliary neurotrophic factor(CNTF) on promoting nerve regeneration in sciatic nerve in rats. Methods The newly double channel nerve conduit of fusiform shape is symmetry to the middle axis and its vertical length is 10mm, with outside diameter 2mm and inside diameter 1.8mm. Thirty two rats with 10mm gap of sciatic nerve were randomly divided into two groups, with 16 in each. In group A, 200μl of chitin for medical use was injected into the conduit. In group B, the two branches of the conduit was injected with 100μl of the chitin and 5μl of NGF(20 ng/μl) at the left side, 100μl of the chitin and CNTF (60 ng/μl) at the right side. On postoperative 12 and 16 weeks, the nerve regeneration was evaluated by electrophysiological and morphological assessment.Results There was no statistically significant difference in the nerve regeneration in two braches in group A on postoperative 16 weeks. In group B at the NGF side, there was fair-arranged nerve fiber, mainly with myelinated nerve, and with thick myelin large axon diameter. In group B at the CNTF side, well arranged and distributed nerve fiber was observed. The number of myelinated and unmyelinated nerve was increased. The motor nerve conduction velocity in the NGF branch was slower than that in the CNTF side. The latency of compound motor action potential and cortical somatosensory evoked potential in the NGF side was longer than that in the CNTF side, but the amplitude in the NGF side was lower than that in the CNTF side.Conclusion NGF can promote the regeneration and myelinogeny of myelinated fiber. CNTF can promote the regeneration of both myelinated and unmyelinated fiber, and its functional recovery is superior to that of NGF.

关 键 词：CNTF NGF 神经生长因子 睫状神经营养因子 周围神经再生 医用几丁糖 术后 排列 促进 结论 

分 类 号：R651[医药卫生—外科学] R338[医药卫生—临床医学]