活性组织工程神经移植体桥接坐骨神经损伤:存活时间及功能恢复的量化评估  

Living tissue-engineered nerve transplant bridging sciatic nerve lesion:Quantitative evaluation of survival time and functional restoration

作　　者：张军[1] 许百男[1] 周定标[1] 道格拉斯.史密斯 

机构地区：[1]解放军总医院神经外科,北京市100853 [2]宾夕法尼亚大学神经外科,美国费城19104

出　　处：《中国组织工程研究与临床康复》2007年第16期3018-3021,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：美国NIH grants资助课题(AG21527;NS38104;NS46170)~~

摘　　要：目的:利用组织工程方法制备的神经组织替代物桥接大鼠坐骨神经缺损,观察移植体的存活时间和神经功能指数。方法:实验于2001-04/2003-01在宾夕法尼亚大学神经外科颅脑创伤中心实验室完成。实验方法:利用神经轴索可以体外机械拉长的特性,将背根神经节神经元和拉长的轴索经凝胶处理后,一并卷入可吸收的聚乙醇酸导管内,制备出具有生物学活性的组织工程神经移植体。选用成年雄性SD大鼠40只,按随机数字表法分为4组,每组10只。建立大鼠坐骨神经损伤模型,组织工程替代物移植组将长约12mm的组织工程神经移植体桥接于坐骨神经缺损处;自体神经移植组将切除的坐骨神经近远端调转后重新缝合回缺损处;损伤模型组切除神经后无修复;对照组未造成损伤。实验评估:术后15周,分别对各组大鼠进行行为学评估,比较坐骨神经功能指数,其绝对数值与坐骨神经功能呈负相关。术后16周,处死动物前检测坐骨神经的传导速度,处死动物后行病理学检查,坐骨神经标本切片分别行苏木精-伊红、降钙素基因相关的缩氨酸抗体(背根神经节神经元标记物)、神经丝蛋白和髓鞘染色。结果:40只大鼠全部进入结果分析,无脱失。①术后15周,损伤模型组大鼠的坐骨神经功能指数绝对值高于组织工程替代物移植组和自体神经移植组(-94.3±2.55,-80.0±1.2,-82.7±2.7,P<0.05),两移植组差异无显著性意义(P>0.05)。对照组大鼠的坐骨神经功能指数为(-6.08±1.6),其绝对值显著低于其他3组(P<0.05)。②术后16周,对照组、组织工程替代物移植组、自体神经移植组大鼠的坐骨神经传导速度分别为(51.2±3.1,12.4±2.3,12.0±2.5)m/s,损伤模型组无动作电位引出,对照组大鼠的坐骨神经传导速度高于其他各组(P<0.01),两移植组差异无显著性意义(P>0.05)。③术后16周,自体神经移植组和替代物移植组中,大体检查可见相对正�AIM： To transplant a tissue engineered nerve substitute was into the sciatic nerve injury gap of rats so as to observe the survival time and nerve function index of the transplant. METHODS： The experiment was performed at the Central Laboratory of Craniocerebral Trauma, Department of Neurosurgery, University of Pennsylvania from April 2001 to January 2003. Experimental methods： The tissue engineered nerve construction： Dorsal root ganglia （DRG） neurons were harvested from rats, dissociated and grown in vitro using a uniquely designed stretch-growth axon elongation device in polyglycolic acid tube. Totally 40 adult male SD rats were selected and randomly divided into 4 groups with 10 in each group. Models of injury of sciatic nerve were established. About 12 mm long tissue engineered nerve substitute was transplanted in the region of sciatic nerve injury in the tissue engineered transplant group. After exchange, the proximal and distal excisional sciatic nerve was sutured in the defect region in the autologous nerve transplantation group. There was no repair after excising nerve in the injured model group, and no injury occurred in the control group. Experimental assessment： 15 weeks after operation, the behavior of rats was detected in each group to compare sciatic nerve function index, and its absolute number was negatively associated with sciatic nerve function. 16 weeks after operation, conduction speed of sciatic nerve was determined before killing animals. Pathology test was done after killing animals. Sciatic nerve sample sections were treated with haematoxylin-eosin, calcitionin gene correlated peptide antibody （marker of dorsal root neurons）, neurofilament protein and myelin staining. RESULTS： A total of 40 rats were involved in the result analysis, no drop-out. （1）15 weeks after transplantation, absolute value of sciatic nerve function index in injured model group was higher than that in the tissue engineered transplant group and autologous nerve transplantation group （-94.3

关 键 词：神经移植 周围神经/损伤 疾病模型 动物 组织移植 

分 类 号：R622.3[医药卫生—整形外科]