优化法去细胞神经同种异体及异种移植的比较  

Compare of the capability of optimized acellular allograft and xenograft reparing rat sciatic nerve defect

作　　者：陈冠军 夏莉华 马长生 杨兴洁[2] 

机构地区：[1]总装备部后勤部亚运村门诊部,北京100101 [2]北京回龙观医院一科,北京100101

出　　处：《中华显微外科杂志》2012年第1期35-39,96,共6页Chinese Journal of Microsurgery

摘　　要：目的分别以优化法去细胞（OA）大鼠坐骨神经及兔臂丛分支移植修复大鼠坐骨神经缺损，观察免疫排斥情况、早期功能恢复及神经再生情况，以比较此优化法处理的同种异体及异种神经移植物修复周围神经缺损的能力。方法以新鲜新西兰大白兔臂丛分支、自体坐骨神经、OA处理过的新鲜取材的sD大鼠坐骨神经及新西兰大白兔臂丛分支。移植修复成年sD大鼠坐骨神经1．0em缺损，即新鲜异种神经移植组、自体神经移植组、OA异种神经移植和OA异体神经移植组，分别于术后1个月及3个月行功能评价（SFI）、电生理（CV）和组织学检查，观察免疫排斥、功能恢复及神经再生情况。结果术后1个月，OA异体和OA异种神经移植组的SFI、CV、轴突密度分别为：61．38±5．59、（32．23±0．91）m／s、（22．26±1．74）m／s和（0．782±0．081）（个／100μm。），3个月分别为59．00±5．40、（31．80±0．99）m／s、（23．35±2．40）m／s和（0．778±0．046）（个／100μm。）；术后1个月，异体和异种神经移植CD8＋T细胞和巨噬细胞染色阳性百分比分别为0．17385±0．01805、0．09299±0．01565和0．30223±0．09449、0．19537±0．02010。同种异体神经移植组与异种神经移植组在免疫排斥、功能恢复及神经再生方面差异无统计学意义（P〉0．05），且都明显优于未处理新鲜神经移植组（P〈0．05）。3个月时的神经再生及功能恢复情况优于1个月组（P〈0．05）。结论优化去细胞法处理的同种异体及异种神经移植物在修复周围神经缺损时，均可以达到免疫耐受．移植动物早期功能恢复和神经再生情况良好。To compare the capability of optimized acellular（OA） allograft and xenograft reparing rat sciatic nerve defect by observing the immunological rejection, early functional recovery and nerve regeneration in the adult rats, which had been made a 1.0cm long gap in the continuity of the sciatic nerve. Methods The right sciatic nerve of adult Sprague Dawley（SD） rats were exposed and 1.0cm long segment of the nerves were removed and repaired by fresh rabbit nerve and autofrafts, OA rat and rabbit nerve. After 1 and 3 months respectively, sciatic functional index （SFI）, electrophysiological and histology studies were detected to evaluate immunological rejection, early functional recovery and nerve regeneration. Results The immunological rejection, functional recovery and nerve regeneration in OA xenografts were compared with that in OA allografts, autografts and fresh allografts. One month after the surgery, the levels of CD8~ T cells and macrophages that infiltrated the grafts, the SFI and the axon density at the midpoints of them were similar within OA grafts and autografts（P 〉 0.05）, but all statistically distinguishable from fresh allografts（P 〈 0.05）. And better results were got after 2 months（P 〈 0.05）. Conclusions The results imply that OA xenografts is as good as OA allografts, which can be immunologically tolerated and that the removal of cellular material and preservation of the matrix are beneficial for promoting regeneration and functional recovery through an OA procedure. And this gives another promising option to repair peripheral nerve defect.

关 键 词：坐骨神经 同种异体神经移植 异种神经移植 免疫排斥 神经再生 

分 类 号：R651.3[医药卫生—外科学]