睫状神经营养因子涂层的聚羟基乙酸聚乳酸神经导管修复犬胫神经缺损  

Ciliary neurotrophic factor-coated polyglecolic-polylactic acid nerve conduits to repair canine tibial nerve defects

作　　者：沈尊理[1] 沈华[1] 张菁[2] 张佩华[3] 王文祖[3] 陈南墚[3] 郯志清[4] 王永春[1] 连峰[1] 

机构地区：[1]上海交通大学附属第一人民医院整形外科,上海市200080 [2]东华大学理学院 [3]东华大学纺织学院 [4]东华大学材料学院

出　　处：《中华显微外科杂志》2006年第5期347-349,i0004,共4页Chinese Journal of Microsurgery

基　　金：上海市科委招标课题(02DZ11007);上海市科技攻关项目(027252045);上海市自然科学基金项目(03ZR14075)

摘　　要：目的探讨应用脉冲等离子体方法涂层睫状神经营养因子(CNTF)的聚羟基乙酸聚乳酸(PGLA)神经导管修复犬胫神经缺损的疗效。方法18只杂交犬,每只犬左后肢制成胫神经2．5 cm缺损模型,随机分别应用三种方法修复。A组：应用脉冲等离子体方法涂层CNTF的PGLA神经导管；B组：单纯PGLA神经导管；C组：自体神经。应用苏木精-伊红和Masson染色、S-100免疫组化染色、神经电生理及神经轴突计数方法评价神经再生效果。同时动态记录犬行走步态变化,实验观察期3个月。结果神经导管血管化良好且大部分降解吸收,再生神经均已通过所有神经导管。A组与C组的神经传导速度和神经轴突计数差异无统计学意义(P＞0．05),而A组和C组的数据均优于B组(P＜0．05)。A组和C组的犬基本恢复正常行走步态,而B组犬仍有跛行。结论脉冲等离子体方法涂层CNTF的PGLA神经导管能有效修复犬2．5 cm胫神经缺损,取得与自体神经相近的效果。Objective To explore the effect of ciliary neurotrophic factor （CNTF）-coated polyglycolic and polylactic acid （PGLA） nerve conduits treated by pulsed plasma to repair canine tibial nerve defects, Methods A 2.5 cm long tibial nerve defect was made in eighteen cross-bred dogs, The nerve defects were reconstructed by three different methods ： group A ： pulsed plasma treated and CNTF coated PGLA nerve conduits （ n = 6） ; group B ： PGLA nerve conduits alone （ n = 6） ; group C ： nerve autografts （ n = 6）. HE staining, Massons＇ trichrome staining, S-100 immunostaining, electrophysiological test and axon counting were used to evaluate the results of nerve regeneration in three groups. In addition, the dynamic walking pattern was recorded individually. The ohservation period lasted for three months, Results All nerve conduits were well vas- cularized and mostly degraded as well as absorbed, It was found that the regenerating axons could traverse all nerve conduits. In regard to nerve conduction velocity and axon counting there was no significant difference between group A and group C （ P 〉 0, 05 ）, while the data of group A and group C were significantly better than those of group B（P 〈0, 05 ）. The dogs in group A and C recovered nearly normal walk pattern while those in group B were still crippled, Conclusion Pulsed plasm-treated and then CNTF-coated PGLA nerve conduits could effectively repair 2. 5-cm-long canine tibial nerve defects, and the effect is similar to that of autografts.

关 键 词：外周神经 神经导管 脉冲等离子体 睫状神经营养因子 犬 

分 类 号：R651.3[医药卫生—外科学]