慢性骨筋膜室综合征压迫解除后的骨骼肌再生能力  

Regenerative capacity of skeletal muscle after relieving compression of chronic osteofascial compartment syndrome

作　　者：马童[1] 白跃宏[1] 俞红[1] 

机构地区：[1]上海交通大学附属第六人民医院康复科,上海市200233

出　　处：《中国组织工程研究与临床康复》2007年第36期7176-7180,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：上海市登山行动计划重点课题(064119534)~~

摘　　要：目的:探讨慢性骨筋膜间隔综合征所致比目鱼肌损伤后的肌纤维病理改变及再生能力。方法:实验于2005-08/2006-04在上海市第六人民医院中心实验室完成。①实验动物:20周龄新西兰白兔102只,取6只作为正常对照组,其余96只随机数字表法分为4组:80mmHg压迫3d组、120mmHg压迫3d组、80mmHg压迫14d组、120mmHg压迫14d组,24只/组。②实验方法:除正常对照组外,各组按其对应的压力强度和压迫时间建立骨筋膜间隔压力模型,采用充气式血压计袖带于每只兔的右小腿给予间断、重复性的压迫,2次/d,2h/次,中间休息30min。③实验评估:压迫试验结束后1,7,14,28d,选取比目鱼肌损伤最重区域制作标本,光镜及透射电镜下观察肌纤维组织病理学变化,同时以计算机图像分析系统检测骨骼肌细胞坏死纤维化面积。结果:102只兔均进入结果分析。①骨骼肌组织病理学变化:80mmHg压迫3d组、120mmHg压迫3d组解除压迫后1d,骨骼肌局灶坏死,基底膜完整;解除压迫后7d大量肌卫星细胞增殖,可见肌管融合;解除压迫后14d骨骼肌恢复较完全,仅少量纤维化;至解除压迫后28d与正常对照组无明显区别。80mmHg压迫14d组、120mmHg压迫14d组解除压迫后1d,大面积肌纤维坏死与间质纤维化,基底膜大部分崩解,可见肌卫星细胞增殖;解除压迫后7d于残存基底膜附近可见片灶状卫星细胞增殖;解除压迫后14d肌卫星细胞已停止大量增殖;解除压迫后28d仍可见大面积纤维化,且面积已趋稳定。②骨骼肌细胞坏死纤维化程度:正常对照组骨骼肌细胞坏死纤维化面积为(1.0±0.5)%。压迫试验结束后1d,120mmHg压迫3d组骨骼肌细胞坏死纤维化面积明显高于80mmHg压迫3d组(P<0.05);压迫试验结束后7,14d,两组基本相似,至28d均恢复至正常对照组水平(P>0.05)。压迫试验结束后各时间点120mmHg压迫14d组骨骼肌细胞坏死纤维化面积均明显高于80mmHg压迫14d组(P<0.05)。③�AIM： To elucidate pathological changes and regeneration capacity in the soleus muscle after muscle damage induced by chronic compartment syndrome. METHODS; The experiment was performed at Central Laboratory of Shanghai Sixth People＇s Hospital from August 2005 to April 2006. ①One hundred and two New Zealand white rabbits aged 20 weeks were selected. Six rabbits were allocated as normal control group, and ninety-six rabbits were allocated into four groups by method of random digits table, Group Ⅰ, with 80 mm Hg for 3 days, Group Ⅱ, with 120 mm Hg for 3 days, Group Ⅲ, with 80 mm Hg for 14 days, Group Ⅳ, with 120 mm Hg for 14 days with 24 in each group. ②Except the normal control group, compartment compression models were established based on pressure intensity and compression time. Interruptable and repeated tourniquet compression via cuff inflation was carried out on the right leg of each rabbit, twice a day, 2 hours once with an interval of 30 minutes. ③Severe injured soleus muscle was collected to prepare specimens at days 1, 7, 14 and 28 after compression. Histopathological change of muscle fiber was studied under light microscope and transmission electron microscope. Simultaneously, areas of fibrosis and necrosis were determined by computer image analysis system. RESULTS： 102 rabbits were involved in the result analysis. ①Histopathological change： In Group Ⅰ and Group Ⅱ one day after compression, a few necrotic fibers were observed and basal lamina were integrity; 7 days after compression, there were lots of proliferation of satellite cells, and myotube could be seen; 14 days after compression, regeneration of muscles were complete with only a small quantity of fibrosis; 28 days after compression, it was no significant difference compare with normal control group. In Group Ⅲ and Group Ⅳ, 1 day after compression, a large area fibers were necrotic, and the interstitium exhibited fibrosis, basal lamina were disintegration, satellite cell proliferation appeared; 7 days later, the pro

关 键 词：骨骼肌 慢性骨筋膜间隔综合征 再生 

分 类 号：R686.3[医药卫生—骨科学]