外源性表皮生长因子与端侧吻合后的神经再生(英文)  

Role of exogenous epidermal growth factor in nerve regeneration after terminol ateral neurorrhaphy

作　　者：尚咏[1] 汪爱媛[2] 卢世璧[2] 余征[2] 

机构地区：[1]解放军空军总医院骨科,北京市100036 [2]解放军总医院骨科研究所,北京市100853

出　　处：《中国临床康复》2005年第14期252-253,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:研究证实通过端侧吻合方式可诱导神经侧芽再生,但再生效果达不到神经端端吻合的水平,应用外源性表皮生长因子具有促进体外神经元存活及神经再生的效果,可否提高端侧周围神经吻合的再生率?目的:评价外源性表皮生长因子对端侧吻合后神经远段再生的影响。设计:随机对照实验。单位:解放军总医院骨科研究所。对象:实验于2001-09/2002-02在解放军总医院骨研所完成。雄性Wister大白鼠32只,体质量200～250g,随机分成表皮生长因子组和对照组,每组16只。方法:表皮生长因子组:切断右侧腓神经,在邻近的胫神经干外膜上开一1mm小窗,将腓神经远端吻合到胫神经干侧方开窗处。右小腿外侧肌肉注入用生理盐水稀释为2g/L的表皮生长因子注射液0.1mL/d,共用2周;对照组:吻合方法同表皮生长因子组,术后注射等量的生理盐水2周。两组分别于术后4周和8周进行大体、组织学、形态定量学和电生理检测。主要观察指标:两组术后有髓神经纤维再生率,运动神经传导速度,超微结构变化。结果:32只大鼠均进入结果分析。①有髓神经纤维再生率:术后4,8周时,表皮生长因子组优于对照组(52.42±1.45)%,(61.41±1.54)%,(34.60±1.52)%,(38.64±1.89)%,P<0.05。②运动神经传导速度:术后4,8周表皮生长因子组明显比对照组加快(30.33±0.88)m/s,(34.BACKGROUND:It is proved that nerve regeneration induced by terminolateral neur orrhaphy(TLN) is not as active as that induced by end to end suture.Exogenous epidermal growth factor(EGF) increases the opportunity of neuron survival in vit ro and promotes nerve regeneration.Whether it can increase nerve regeneration af ter terminolateral neurorrhaphy deserves further study. OBJECTIVE:To evaluate the effect of exogenous EGF in promoting nerve regenerat ion after terminolateral neurorrhaphy. DESIGN:A randomized controlled trial. SETTING:Orthopedic Institute of Chinese PLA General Hospital. PARTICIPANTS:The trial was conducted in the Orthopedic Institute of Chinese PL A General Hospital from September 2001 to February 2002.A total of 32 male Wista r rats,weighting 200-250 g,were randomized to control group and EGF group with 16 rats in each group. METHODS:The right peroneal nerve was transected and an epineural window of 1 m m was created on the neighboring tibial nerve.The distal end of the transected p eroneal nerve was sutured to the windowed tibial nerve by means of end to side attachment.Each rat in EGF group received injection of 0.1 mL/d EGF diluted wit h normal saline at 2 g/L for two weeks while each in control group received inje ction of normal saline(0.1mL/d) at the distal site of the transected peroneal ne rve for two weeks.Histological,morphological and electrophysiological examinatio ns were performed 4 and 8 weeks after operation. MAIN OUTCOME MEASURES:The regeneration rate of myelinated nerve,motor nerve co nduction velocity and ultrastructural changes of the two groups. RESULTS: All the 32 rats entered the results analysis.①The regeneration rate of myelinated nerve fibers:4 and 8 weeks after operation,it was better in EGF gr oup[(52.42±1.45)%and(61.41±1.54)%]than that in control group[(34.60±1.52 )%and(38.64±1.89)%](P< 0.05).②Motor nerve conduction velocity:4 and 8 wee ks after operation,it was obviously greater in EGF group[(30.33±0.88)m/s and( 34.36±1.09)m/s]than that in control group[(21

关 键 词：外源性表皮生长因子 神经再生 吻合后 端侧 运动神经传导速度 解放军总医院 神经纤维再生 WISTER 随机对照实验 超微结构变化 吻合周围神经 生理盐水 神经元存活 骨科研究所 对照组 电生理检测 形态定量学 超微结构观 吻合方式 

分 类 号：R338[医药卫生—人体生理学] R651.3[医药卫生—基础医学]