脉冲超声波治疗对大鼠膝关节内侧副韧带损伤愈合的影响  

The effect of pulsed ultrasound on medial collateral ligament repair

作　　者：樊永梅[1] 张长杰[1] 伍源[1] 吕兰[1] 

机构地区：[1]湘雅二医院康复科,长沙410011

出　　处：《中华物理医学与康复杂志》2010年第3期169-172,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的通过检测转化生长因子-β1（TGF-β1）在大鼠膝关节内侧副韧带（MCL）损伤模型中的表达以及观察局部瘢痕愈合的情况，探讨脉冲超声波治疗对韧带损伤愈合的作用。方法选择18只Sprague—Dawley大鼠，行内侧副韧带切断术，造模成功后随机分为对照组、0．5W／cm^2超声组和1．0W／cm^2超声组。对照组不予以治疗，0．5W／cm^2超声组和1．0W／cm^2超声组依次予以每天10min相应强度的脉冲超声波治疗，治疗8d后处死各组大鼠。大体观察各组大鼠局部韧带愈合的情况后，取内侧副韧带进行苏木素-伊红（HE）染色、VanGieson（VG）染色及免疫组织化学染色，观察并比较各组大鼠炎症细胞浸润、胶原纤维排列情况及TGF-β1表达强度。结果①肉眼观察：断裂的内侧副韧带均以瘢痕组织形式愈合，与对照组比较，2个超声组的瘢痕组织明显增大。②HE染色以及VG染色后光镜下观察：对照组中炎症细胞以及新生血管数较2个超声组少，并且对照组胶原纤维排列较0．5W／cm^2超声组、1．0W／cm^2超声组紊乱。③0．5W／cm^2超声组、1．0W／cm^2超声组的TGF-β1表达较对照组强，差异有统计学意义（P〈0．05）；1．0W／cm^2超声组的TGF-β1表达较0．5W／cm^2超声组强，差异有统计学意义（P〈0．05）。结论①脉冲超声波治疗韧带损伤，可使局部瘢痕组织增生，炎症反应增强，胶原纤维排列规则，从而改善近期软组织愈合，远期效果尚待进一步研究。②软组织损伤后，脉冲超声波治疗可以促进TGF-β1表达增加；并且治疗强度增大，TGF-β1表达增强。③脉冲超声波治疗可能通过促进TGF-β1表达而促进软组织愈合。Objective To investigate the effect of pulsed ultrasound therapy （US） on medial collateral ligament healing in rats and it＇s mechanism. Methods Eighteen 3-month-old male Sprague-Dawley rats with transected medial collateral ligaments （MCLs） were studied. They were randomly divided into a control group, a 0.5 W/cm2 group and a 1. 0 W/cm2 group. The control group was not given any treatment. The 0. 5 W/cm2 group and 1.0 W/cm2 group were given 10 minutes of pulsed US （duty cycle： on/off = 3 ms/1 ms） daily for 8 days at either 0.5 or 1.0 W/cm2 intensity. All the rats were sacrificed on the 9th day. After macroscopic examination, their MCLs were harvested and studied using haematoxylin-eosin staining, Van Gieson＇s staining and immunohistochemical techniques in order to detect transforming growth factor beta-1 （TGF-β1） and any histological or histochemical changes. Results Macroscopically, the lacerated MCLs had healed with scar tissue formation. Scarring appeared to be greater in the 0.5 W/cm2 and 1.0 W/cm2 groups than in the control group. Inflamed cells appeared to be more numerous in the treated groups than in the controls. There were significant differences in collagen fiber extent among all three groups. In the 1.0 W/cm2 group, the average level of TGF-β1 was significantly up-regulated, and TGF-β1 expression was higher than in the other two groups. Conclusions Pulsed US can improve ligament healing in the short term, however whether long-term treatment with US can yield further improvement is unknown. Pulsed US can increase the level of TGF-β1, which will be higher with higher US dosage. Pulsed US may enhance injured ligament repair by up-regulating TGF-β1.

关 键 词：超声波治疗 内侧副韧带 转化生长因子-Β1 修复 

分 类 号：R686[医药卫生—骨科学]