干扰素/聚乳酸-羟基乙酸共聚物及壳聚糖/聚乳酸-羟基乙酸共聚物复合膜防止椎板切除术后硬膜外瘢痕粘连的实验  

Preventing epidural scar adhesion after laminectomy using interferon/poly(lactic-co-glycolic acid) and chitosan/poly(lactic-co-glycolic acid) composite membrane

作　　者：苏云[1] 孟祥俊[1] 于小光[1] 孙强[1] 张新[2] 景遐斌[3] 

机构地区：[1]大连大学附属中山医院骨科,辽宁省大连市136001 [2]吉林大学第一医院骨科,吉林省长春市130021 [3]中科院长春应用化学研究所,吉林省长春市130021

出　　处：《中国组织工程研究与临床康复》2008年第23期4427-4430,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:应用硬膜外阻隔材料是预防椎板切除术后硬膜外瘢痕粘连的一种方法,而制备既有机械阻隔能力,又有抑制成纤维细胞的能力的复合膜是其研究方向。目的:制备壳聚糖/聚乳酸-羟基乙酸共聚物[poly(lactic-co-glycolic acid),PLGA]与干扰素/PLGA复合膜,观察其防止椎板切除术后硬膜外瘢痕粘连的作用。设计、时间及地点:2005-05/2007-04在中科院长春应用化学研究所完成材料制备,随机对照动物实验在解放军第二○八医院实验动物室完成。材料:PLGA膜、壳聚糖/PLGA及干扰素/PLGA复合膜由中科院长春应用化学研究所制备。方法:大耳白兔120只行L2及L4椎板切除,随机分为6组,每组20只,于椎板缺损区处理如下:①空白对照组:硬膜外不放任何物质。②自体游离脂肪组:取皮下脂肪贴于硬膜表面。③透明质酸钠组:透明质酸钠1mL涂于硬膜外。④PLGA膜组、壳聚糖/PLGA及干扰素/PLGA复合膜组:分别将各种膜修剪成合适大小植于硬膜外。主要观察指标:术后2,4,6,8周处死动物,观察L2手术区硬膜外瘢痕形成及粘连程度并评分,然后完整取下L4节段脊柱,行苏木精-伊红染色及Masson染色,光镜下观察并行组织学评分。结果:随着时间的延长,空白对照组形成较广泛的瘢痕;自体游离脂肪组和PLGA膜组的瘢痕量少于对照组,前两者比较差异无显著性;透明质酸组早期瘢痕形成量明显少于自体游离脂肪组和PLGA膜组,后期差异无显著性,但仍优于空白对照组;壳聚糖/PLGA膜组与干扰素/PLGA膜组硬膜外瘢痕的形成量最少,与硬膜无或轻微粘连,明显优于其他各组,两种复合膜组间差异不明显。结论:壳聚糖/PLGA与干扰素/PLGA复合膜均可预防椎板切除术后硬膜外瘢痕粘连,效果相近。BACKGROUND： Epidural resistance materials are an approach to prevent the epidural scar adhesion after laminectomy. A composite membrane of mechanical separation and fibroblast inhibition is promising to be studied widely. OBEJCTIVE： To prepare the interferon （IFN）/poly（lactic-co-glycolic acid） （PLGA） and chitosan/PLGA composite membranes, and to observe their effect on preventing epidural scar adhesion after laminectomy. DESIGN, TIME AND SETTING： The materials were prepared in Changchun Institute of Applied Chemistry, Chinese Academy of Sciences; The randomized control animal tests were fulfilled in Animal Experimental Room of the 208 Hospital of Chinese PLA from May 2005 to April 2007. MATERIALS： PLGA membrane, chitosan/PLGA composite membrane and IFN/PLGA composite membrane were prepared in Changchun Institute of Applied Chemistry, Chinese Academy of Sciences. METHODS： L2 and L4 laminectomies were performed in 120 rabbits, which were then randomly divided into six groups （n=20）： Blank control group received nothing on epidurals; Autogenous free fat group： The exposed duras were covered with subcutaneous fat; Sodium hyaluronate group： 1 mL sodium hyaluronate was dripped on dura maters; PLGA membrane, chitosan/PLGA composite membrane and IFN/PLGA composite membrane groups： The exposed duras were covered with one of the three membranes at a suitable size. MAIN OUTCOME MEASURES： The animals were killed at 2, 4, 6 and 8 weeks postoperatively. The scar formation and adhesion to the dura in l〈 laminectomy site were observed and scored. The whole L4 vertebrae were obtained to perform the hematoxylin-eosin and Masson stains, then the histological evaluation was made. RESULTS： With time going on, widespread scars formed in the blank control group. The scars in the fat group and PLGA group were less than that in the control group, but no significant difference was found between the fat and PLGA groups. In early stage, the scars in the sodium hyaluronate group were obviou

关 键 词：PLGA 干扰素 壳聚糖 硬膜外瘢痕 生物材料 

分 类 号：R318[医药卫生—生物医学工程]