碱性成纤维细胞生长因子复合降解膜对自体神经移植的影响  

Effect of basic fibroblast growth factor combined with degradable membrane on autogenous nerve transplantation

作　　者：尚宇阳[1] 辛畅泰[2] 杨晓霞[3] 王春渤[2] 魏侃[2] 徐媛[2] 安贵林[2] 

机构地区：[1]沈阳市红十字会医院手外科,辽宁省沈阳市110013 [2]沈阳医学院奉天医院手外科研究所,辽宁省沈阳市110024 [3]沈阳医学院中心实验室,辽宁省沈阳市110034

出　　处：《中国临床康复》2006年第17期110-112,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:用碱性成纤维细胞生长因子复合降解膜包裹自体神经移植部位观察其对神经再生的影响。方法:实验于2002-05/2003-08在沈阳医学院奉天医院手外科研究所完成。取健康成年新西兰大耳白兔30只,将兔左、右肢正中神经切除3cm,并用左、右肢切下来的神经互换移植。其中,左肢神经移植处包裹碱性成纤维细胞生长因子复降解膜为实验侧,30例;右肢神经移植处包裹不含碱性成纤维细胞生长因子复合剂的降解膜为对照侧,30例。术后3,12,24周切取神经移植部,制成光、电镜标本和血-神经屏障HRP示踪标本,镜下观察组织学变化,显微图像分析测定有髓神经再生情况。结果:实验大白兔30只均进入结果分析。①实验侧的再生有髓神经纤维在数量和直径上较对照侧差异有显著性[数量:实验侧近端为(648±144)条,远端为(504±82)条;对照侧近端为(614±178)条,远端为(224±59)条,P<0.001。直径:实验侧近端为(4.5033±0.5461)μm,远端为(3.8000±0.7329)μm,对照侧近端为(4.4783±1.2689)μm,远端为(2.5416±0.7214)μm,P<0.01]。②实验侧神经缝合段组织增生明显较对照侧的少,粘连程度明显较对照侧的轻(实验侧:无粘连0,轻度粘连85.7%,中度粘连14.3%,重度粘连0;对照侧:无粘连0,轻度粘连14.3,中度粘连14.3%,重度粘连71.4%)。③实验侧肌电反应强度明显优于对照侧[潜伏期:实验侧(4.94±0.897)ms,对照侧(7.30±1.620)ms,P<0.01]。④实验侧神经移植段的血-神经屏障功能较对照侧恢复快。结论:包裹成纤维细胞生长因子复合降解膜有减轻移植神经局部结缔组织增生、加速血-神经屏障功能恢复和促进神经再生的作用。增强神经自身再生能力结合抑制结缔组织增生可能是提高神经再生效果的新思路。AIM： To wrap the autogenous nerve transplantation site with the basic fibroblast growth factor （bFGF） combined with degradable membrane, so as to observe its effect on nerve regeneration, METHODS： The experiment was conducted in the Institute of Hand Surgery, Fengtian Hospital Affiliated to the Shenyang Medical College between May 2002 and August 2003, Totally 30 healthy adult New Zealand White Rabbits were selected. 3 cm median nerve in the left and right arms was cut off, and was interchange transplanted. The nerve transplantation site of the left arm wrapped with bFGF combined with degradable membrane was the experimental side （n=30）; the right arm wrapped with degradable membrane without bFGF complex was the control side （n=30）. The nerve transplantation site was cut off after 3, 12 and 24 weeks of operation, respectively to prepare the samples for light-electron microscope and the blood-nerve barrier （BNB） HRP-tagging samples. The histological change was observed under the microscope, and the regeneration of myelinated nerve was detected with the micro-image analysis system. RESULTS： All the 30 rabbits were involved in the result analysis. ①There were significant differences in the number and diameter of the regeneration myelinated nerve fiber between the two sides [Numbe： the experimental side： near end （n=648±144）, far end （n=504±82）; the control side： near end （n=614±178）, fax end （n=224±59）, P 〈 0.001. Diameter： the experimental side near end （4.503 3±546 1）μm, far end （3.800 0±0.732 9）μm; the control sid± near end （4.478 3±1.268 9） tan, far end （2541 6±0.721 4）μm, P 〈 0.01]. ②The tissue proliferation in the nerve sutured site of the experimental side was obviously less than the control side, and the adherent degree was also much lighter than the control side （the experimental side： no adherence 0, mild adherence 85.7%, moderate adherence 14.3%, close adherence 0; the control side： no adherence 0, mild adherence 14.

关 键 词：移植 自体 成纤维细胞生长因子 神经再生 

分 类 号：R318.01[医药卫生—生物医学工程]