复合许旺细胞的猪肠黏膜下层桥接修复周围神经缺损  

Repairing peripheral nerve defect using porcine small intestinal submucosa bridging contained Schwann cells

作　　者：韩同坤 窦庆寅[1] 陈峰[1] 胡洪涌[1] 阳闽军[1] 蔡卫东[1] 梁旭强 

机构地区：[1]深圳市宝安区松岗人民医院骨科,广东省深圳市518105

出　　处：《中国组织工程研究与临床康复》2008年第49期9635-9638,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：深圳市宝安区科学技术局资助项目(2005222)~~

摘　　要：背景:小肠黏膜下层作为一种天然的生物材料,能提供适合神经生长的三维支架,而许旺细胞又在神经再生过程中发挥重要作用。如果能将许旺细胞种植在小肠黏膜下层,用来桥接周围神经缺损,理论上更有利于神经的长入,极有可能获得良好的实验效果。目的:应用复合有许旺细胞的小肠黏膜下层桥接周围神经缺损,观察桥接后神经生长情况。设计、时间及地点:对比观察实验,于2008-01在深圳市松岗人民医院完成。材料:取健康成年猪的新鲜近段空肠制备小肠黏膜下层。方法:SD大鼠20只随机分成2组,即复合有许旺细胞的小肠黏膜下层桥接组、自体神经移植组。每组10只。首先在距坐骨神经出口1cm处用双面刀片切取1cm长度的坐骨神经,造成神经缺损模型。然后分别用复合有许旺细胞的小肠黏膜下层桥接、自体神经移植桥接。主要观察指标:于术后6,12周自近端缝合口的近端至远端缝合口的远端切取大鼠的坐骨神经,用于病理组织学观察并进行图像分析。同时用生理示波器测定大鼠两侧坐骨神经的潜伏期和诱发电位的波幅。结果:复合有许旺细胞的小肠黏膜下层桥接神经组可见有再生神经组织长过缺损,呈条索状连续,且神经纤维多集中在小肠黏膜下层形成的桥接管周缘区域,而中心区域可见胶原组织且孔隙较多。复合有许旺细胞的小肠黏膜下层桥接神经组潜伏期的延迟率均高于自体神经移植组(P<0.05),而诱发电位的波幅恢复率均低于自体神经对照组(P<0.05)。复合有许旺细胞的小肠黏膜下层桥接神经组轴突的平均直径、单位面积的轴突数量和神经组织所占的百分比均低于自体神经移植组(P<0.05)。结论:复合有许旺细胞的小肠黏膜下层具有促进周围神经轴突再生的作用,但较自体神经移植略差。BACKGROUND： As a natural biological material, the small intestinal submucosa （SIS） can provide three-dimensional scaffold for nerve growth, and Schwann cells play an important role in the process of neural regeneration. Accordingly, in theory, if Schwann cells can be grown in the SIS, and further used to bridge peripheral nerve defects, it will be more conducive to the nerve growth, and most possible to obtain a good test results. OBJECTIVE： To observe the outcomes of bridging peripheral nerve growth using porcine SIS contained schwann cells. DESIGN, TIME AND SETTING： The comparative observation was performed at the Songgang People＇s Hospital of Shenzhen City in January 2008. MATERIALS： Adult healthy pig＇s fresh proximal segment of jejunal loop was prepared for SIS. METHODS： A total of 20 SD rats were randomly divided into the SIS contained Schwann cells and autologous nerve transplantation groups, with 10 rats in each group. At 1 cm defects of sciatic nerve were made in rats and then repaired with SIS contained Schwann cells bridging and auto-nerve grafting respectively. MAIN OUTCOME MEASURES： After 6 and 12 weeks, from the proximal anastomosis of the proximal to distal anastomotic remote rat sciatic nerve were cut, and performed pathological observation and image analysis. Physiological oscilloscope was used to examine the latent period on both sides of rat sciatic nerve and amplitude of evoked potential. RESULTS： In the SIS contained Schwann cells group, the regenerative nerve tissue grew across the defect, nerve fibers mostly aggregated around the peripheral area of the conduits of SIS, and more collagen and holes could be seen in the central area. The delay rate of latent period of the SIS contained Schwann cells group was higher, but the amplitude wave of induced potential was lower than that of the autologous nerve transplantation group （P 〈 0.05）. The average diameter axis-cylinder, quantity of axis-cylinder in per area, and the percentage of neural tissues in the SIS contained

关 键 词：周围神经缺损 小肠黏膜下层 许旺细胞 

分 类 号：R318[医药卫生—生物医学工程]