自体筋膜作为骨骼肌再生支架的实验研究  

Experimental study on the skeletal muscle reconstruction with autologous fascia as a scaffold

作　　者：汪道新[1] 朱志祥[1] 张力勇[1] 黄志斌[1] 关弘[2] 

机构地区：[1]深圳市第二人民医院烧伤整形科,518035 [2]深圳市第二人民医院烧伤病理科,518035

出　　处：《中华烧伤杂志》2005年第3期185-188,共4页Chinese Journal of Burns

摘　　要：目的　探讨自体筋膜作为支架材料在体内重建肌肉的可行性。　方法　采用28只新西兰兔的双后腿建立胫骨前肌中段缺损模型。随机选取一侧,植入用自体阔筋膜制成的支架和肌肉微粒(肌肉支架组);另一侧分为3部分: 10只腿缺损处植入筋膜支架(支架组), 10只腿缺损处植入肌肉微粒(肌肉组), 8只腿缺损不作处理(缺陷组)。术后2、3、4、6、9周分别解剖观察移植成活率,并切取标本行组织学及超微结构观察和结蛋白免疫组织化学鉴定。各时相点切取肌肉支架组和支架组移植物中段标本,用逆转录聚合酶链反应(RT PCR)技术进行α肌动蛋白DNA相对定量分析。结果(1)术后第4周肌肉支架组缺损愈合处形态接近正常,移植成活率达93. 33%,其他组相对较差。(2)肌肉支架组术后2—3周细胞增生活跃,结蛋白阳性率较高,α肌动蛋白DNA相对丰度较大,与支架组比较,差异均有统计学意义(P<0. 05 ).　结论　以自体筋膜为支架促使肌肉组织再生具有可行性。Objective To explore the feasibility of autologous fascia as a scaffold for the reconstruction of skeletal muscle in vivo. Methods Twenty-eight healthy New Zealand rabbits were employed in the study .The anterior tibial muscle in both legs were divided to create a gap of 10 mm in each muscle. One leg was used in the experiment (E, n=28), while the contralateral as self-control (C).The legs in C group were further divided into 3 groups (C1,C2 and C3). While defects in the midportion of anterior tibial muscle in the hind legs were created in all rabbits. In E group, each defect was filled with a tubule made of autologous fascia lata, and the fascial tubule was filled with tiny muscular granules (<1 mm×1 mm×1 mm). In C1 group (n=10), the defect was also filled with fascial tubule but with no muscle filling. The defect in C2 group (n=10) was only filled with muscle granules without fascial tubule. The defect in C3 group (n=8) received no treatment. The survival rate of the transplantation was grossly observed, and the tissue samples were harvested for histological and ultra-structural examination and immunohistochemical identification of desmin at 2, 3, 4, 6 and 9 post-operation weeks. The expression level of α-actin DNA in the tissue samples from the midportion of grafted fascia was assessed by RT-PCR (reverse transcription polymerase chain reaction) in E and C1 groups. Results ① Survival rate of the transplantation: In E group, it was 93.33% with near normal tissue contour in the grafting area. The muscle defects were not completely repaired in C1, C2 and C3 groups. ② Under light and electronic microscopy, marked proliferation of muscular cells surrounding fibrous tissue could be discerned at 2 and 3 post-operation weeks in E group, while only necrotic tissue and fibrosis were observed in C1 and C2 groups, and no definite tissue could be discernible in C3 group. ③Immunohistochemical staining revealed that over 85% of the cells were positive for desmin in E group, while only less than 25% in C1 group

关 键 词：自体筋膜 骨骼肌再生 实验研究 逆转录聚合酶链反应 相对定量分析 肌动蛋白 自体阔筋膜 超微结构观 支架材料 胫骨前肌 新西兰兔 解剖观察 化学鉴定 免疫组织 组织再生 成活率 结蛋白 DNA 肌肉 缺损 植入 术后 组织学 取标本 

分 类 号：R644[医药卫生—外科学]