构建猕猴组织工程化周围神经的实验研究  

An experimental study on reconstruction of rhesus tissue- engineered peripheral nerve

作　　者：胡军[1] 刘小林[1] 朱庆棠[1] 许扬滨[1] 朱家恺[1] 

机构地区：[1]中山大学附属第一医院骨一显微外科医学部,广州510080

出　　处：《中华创伤骨科杂志》2005年第12期1152-1156,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金(30170962);广州市科技攻关重大项目(2002Z1-E0035);广东省自然科学基金(0409399);广东省科技攻关重大项目(2004A30201001)

摘　　要：目的评价组织工程化周围神经修复猕猴4cm尺神经缺损的实验效果,为临床研究提供资料。方法分别用6种移植物桥接4cm尺神经缺损。A组:自体BMSCs+去细胞同种异体神经支架;B组:自体SCs+去细胞同种异体神经支架;C组:自体BMSCs+PLGA支架导管;D组:去细胞同种异体神经支架;E组:PLGA支架导管;F组:自体神经。通过功能学、神经电生理学及组织学研究评价各自的实验效果。结果A、B、C三种组织工程化神经实验组,术后6个月神经电生理和组织学检查,能引起小鱼际肌群产生复合动作电位的潜伏期、复合动作电位的最大振幅、神经传导速度和再生的神经纤维数目与自体神经移植组(F组)相比差异无显著性意义(P>0.05),但分别大于未加细胞的支架组(D、E组),差异有显著意义(P<0.05)。结论用自体源SCs或BMSCs作种子细胞与去细胞同种异体神经支架,或自体源BMSCs与PLGA支架导管构建不同的组织工程化周围神经,修复猕猴4cm尺神经缺损均取得较好的效果。Objective To evaluate the effect of tissue-engineered peripheral nerves （TEPN） on repairing 40-mm ulnar nerve defects in rhesus. Methods Rhesus TEPN was reconstructed using chemically extracted allogenic nerve with implanted autologous Scs （Schwann cells） or BMSCs （bone marrow stromal）, and using bioartificial nerve made by PLGA （polylactic glycolic acid） with implanted autologous MSCs. 36 cases of a 4 cm defect of the ulnar nerve were randomized into 6 groups （n = 6） and repaired by 6 different nerve grafts. Acellular allogenic nerve with implanted autologous BMSCs was used in Group A; acellular allogenic nerve with implanted autologous Scs in Group B; bioartificial nerve with implanted autologous BMSCs in Group C; acellular allogenic nerve in Group D; bioartificial nerve without cells in Group E; autologous nerve graft in Group F. The effects were evaluated in terms of function, electrophysiology and histology. Results 6 months postoperatively, the mean peak of CMAP （compound muscle action potential） and the mean NCV （nerve conduction velocity） in Groups D and E were significantly lower than those in the other 4 groups（ P 〈 0.05）, and the mean latency of onset of CMAP in Groups D and E were significantly longer than those in the other 4 groups, too（ P 〈 0.05） . The differences between the 3 electrophysiological parameters in Groups A, B, C and F were not statistically significant（ P 〉 0.05）. At the middle grafts and the distal host ulnar nerve, the number of the fibers positive to neurofilament in Group F was maximum of all grafts, but there was no statistically significant difference between Groups A, B, C and F （ P 〉 0. 05）. Conclusion The 4 cm-long defect of rhesus ulnar nerve can be repaired by chemically extracted allogenic nerves with implanted cultured autologous SCs or BMSCs, and by using bioartificial nerve made by PLGA with implanted autologous BMSCs. The effects of them are similar to those of autologous nerve graft.

关 键 词：组织工程 周围神经 神经移植 猕猴 

分 类 号：R318.0[医药卫生—生物医学工程]