自组装多肽凝胶联合可降解神经导管修复长节段周围神经损伤  

Combined used of self-assembly peptide and degradable nerve conduit for repair of peripheral nerve injury

作　　者：张伟[1,2] 岳靓[2] 易红蕾[1] 王传峰[1] 陈家瑜[1] 吴冰[1] 魏显招[1] 郯志清[3] 李明[1] 傅强[1] 

机构地区：[1]第二军医大学长海医院骨科,上海200433 [2]解放军第401医院,山东青岛266071 [3]东华大学材料学院,上海201600

出　　处：《中国矫形外科杂志》2011年第24期2083-2087,共5页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目(编号:30872629);全军医学科学技术基金十二五计划重点项目(编号:08G073)

摘　　要：[目的]探讨自组装多肽凝胶联合可降解神经导管修复长节段周围神经损伤的可行性及效果。[方法]选取新西兰大白兔48只,体重1 500 g左右,雌雄不限,按随机数字法分为A:自体神经移植组、B:神经导管+NSCs+NGF组、C:神经导管+IKVAV多肽凝胶+NSCs+NGF组;选取兔坐骨神经,暴露后人为造成10 mm缺损损伤,按照分组分别进行移植修复。术后3、6、9、12周观察兔下肢溃疡形成及愈合情况;术后12周对各组动物进行坐骨神经肌电图检查,处死后取标本观察神经再生情况、小腿三头肌湿重、组织学观察及神经干细胞存活情况。[结果]术后3组动物均出现不同程度的足底溃疡,恢复情况以A组最好,C组次之,B组最差。术后12周神经肌电图、肌肉湿重检测均显示自体神经移植组神经功能恢复良好,优于其余两组(P<0.05)。组织学观察显示C组神经再生情况接近自体神经移植组,明显优于B组。术后12周荧光显微镜下观察到在神经损伤处有绿色荧光蛋白(GFP)荧光表达,神经干细胞仍然存活。[结论]自组装多肽凝胶联合可降解神经导管修复长节段周围神经损伤可以取得良好的疗效。[Objective]To evaluate the feasibility and effect of self-assembled peptide and biodegradable nerve conduit in treating long segment peripheral nerve injury（PNI）.[Method]Forty-eight 1.5 kg-weighed New-Zealand rabbits were included and divided randomly into 3 groups：（A） Auto-nerve transplantation group,（B） Nerve conduct＋NSC＋NGF group,and（C） Nerve conduct＋IKVAV＋NSC＋NGF group.After exposing sciatic nerve and creating a 10 mm defect,we performed different nerve-repair experiments in each group.The ulceration and healing were evaluated at 3,6,9,12 weeks after operation and EMG of sciatic nerve was performed at 12 weeks after operation.The nerve regeneration,wet weight of triceps surae,histology observation and the survival of NSCs were evaluated after rabbits being killed.[Result]Different degree plantar ulcer was observed in all three groups after operation（Severity： Group ACB）.The result of auto-nerve transplantation group was better than that of the others on EMG and muscle wet weight at 12 weeks after operation（P〈0.05）.The nerve regeneration of Group C was quite like that of Group A and far better than that of Group B.Green GFP was observed at the injury site under fluorescence microscope at 12 weeks after operation,and NSCs survived.[Conclusion]Marvelous effect can be obtained in reparation of long segment PNI by means of self-assembled peptide and biodegradable nerve conduit.

关 键 词：自组装多肽 神经导管 坐骨神经 神经干细胞 神经生长因子 组织工程 

分 类 号：R651.3[医药卫生—外科学]