塞来昔布预防肌腱粘连的实验研究  

Experimental study of celecoxib prevention of tendon adhesions

作　　者：孙士温[1] 陆永江[1] 孙海军[1] 吴迎波[1] 杜永军[1] 赵胡瑞[2] 

机构地区：[1]石河子大学医学院,新疆维吾尔自治区石河子832003 [2]中国人民解放军第四七四医院

出　　处：《中国医师杂志》2011年第12期1624-1626,1630,共4页Journal of Chinese Physician

摘　　要：中国医师杂志 Journal of Chinese Physician 2011 Vol.13 No.12 P.1624-1626,1630 目的 探讨塞来昔布对肌腱粘连及肌腱愈合的影响.方法 健康新西兰大白兔54只,随机分为3组：塞来昔布组、布洛芬组、生理盐水组.建立肌腱断裂模型,术后塞来昔布组口服塞来昔布[20 mg/（kg·d）]、布洛芬组口服布洛芬[75 mg/（kg·d）]、生理盐水组予生理盐水.术后4、8周取材,分别进行大体观察、组织学观察、生物力学检测.结果 （1）大体观察：塞来昔布组及布洛芬组随着时间的推移,肌腱均塑形好,表面光滑,并覆以薄膜样组织,容易分离,而生理盐水组随着时间的推移,肌腱与周围组织中等致密粘连,分离较困难；（2）组织学观察：随着时间的推移,塞来昔布组及布洛芬组肌腱与腱周组织之间间隙逐渐清楚,成熟纤维细胞逐渐排列规则且方向一致；而生理盐水组肌腱与腱周组织之间也逐渐有间隙,但成纤维细胞较多且排列不规则；（3）生物力学测定：①肌腱滑动阻力测定：术后4、8周时,塞来昔布组、布洛芬组与生理盐水组肌腱滑动阻力比较,其差异均有统计学意义（0.354 ±0.078/0.382 ±0.121 vs 0.521 ±0.126,P＜0.05；0.075±0.035/0.097±0.043 vs0.414 ±0.110,P＜0.01）；②肌腱最大拉伸断裂强度：术后4、8周时塞来昔布组、生理盐水组与布洛芬组肌腱最大拉伸断裂强度比较,其差异均有统计学意义（36.812 ±6.388 vs 24.899±4.667,P＜0.05;34.297±8.132 vs 24.899±4.667,P＜0.01; 54.515±4.688/59.037±6.606 vs 42.418±5.594,P＜0.01）.结论 塞来昔布能有效预防肌腱粘连,且不影响肌腱愈合.Objective To explore the effect of celecoxib on the tendon adhesion and healing after anastomosis.Methods 54 New Zealand white rabbits were randomly assigned to one of 3 （ celecoxib,ibuprofen,and saline） groups.The deep flexor tendon was transected,followed by a primary repair.The care was begun the day after surgery and was continually provided for 14 days.Celecoxib was given[20 mg/（ kg · d） ],ibuprofen was given [75 mg/（ kg · d） ],or the same volume of saline solution was given respectively.At the 4th and 8th week the animals were killed and assessed by general observation,histologically observation,and biomechanical testing.Results General observation,celecoxib group and ibuprofen group showed good shape of tendons,smooth surface,and covered with a film - like tissue,and it was easy to be separated.Saline group showed that tendon and surrounding tissue medium had dense adhesions,and it was difficult to be separated.Histologically observation showed between tendon and paratenon had clear gap in celecoxib and ibuprofen group.The mature fiber cells gradually arranged rules and in the same direction.Saline between the tendon and paratenon gradually emerged a gap,but more fibroblasts and arranged in irregular.Biomechanical testing showed that tendon sliding resistance appeared in celecoxib and ibuprofen group.Compared with saline group,the differences were statistically significant （0.354 ± 0.078/0.382 ±0.121 vs 0.521 ±0.126,P 〈0.05;0.075 ±0.035/0.097 ±0.043 vs 0.414 ±0.110,P 〈0.01）.UTS （ultimate tensile strength had statistical significance among celecoxib,saline groups and ibuprofen group.（36.812 ±6.388 vs 24.899 ±4.667,P 〈0.05;34.297 ±8.132 vs 24.899 ±4.667,P 〈0.01 ;54.515 ±4.688/59.037 ± 6.606 vs 42.418 ± 5.594,P 〈 0.01 ）.Conclusions Celecoxib can effectively prevent tendon adhesion,and does not affect the tendon healing.

关 键 词：环氧化酶2抑制剂/药理学 黏膜/药物作用 肌腱病/预防和控制 伤口愈合/药物作用 

分 类 号：R687.2[医药卫生—骨科学]