纤溶酶原激活剂(t-PA)促进挤压伤大鼠坐骨神经再生  

Enhancement of regeneration of the crushed sciatic nerve of rat using tissue-type plasminogen activator(t-PA)

作　　者：王德春[1] 陈中伟[1] 陈峥嵘[1] 张乃娴[2] 宋后燕[2] 

机构地区：[1]上海医科大学中山医院骨科,上海市200032 [2]上海医科大学分子遗传研究室

出　　处：《中华显微外科杂志》2000年第2期113-115,共3页Chinese Journal of Microsurgery

基　　金：卫生部直属医疗机构临床学科重点项目!基金 (980 72 )

摘　　要：目的　观察组织型纤溶酶原激活剂 (t- PA)对大鼠坐骨神经挤压伤修复的影响 ,并对其在周围神经再生微环境中的作用进行探讨。　方法　取 36只 Wistar大鼠 ,手术暴露两侧的坐骨神经 ,均造成坐骨神经挤压伤 ,左侧为实验侧 ;右侧为对照侧。实验侧损伤处的坐骨神经外膜下注入 2μl(5μg)t- PA;对照侧则注入 2μl的生理盐水。术后 14、2 8、5 6 d分别进行大体、电生理、组织学观察和形态学分析。　结果　术后 14d时 t- PT治疗侧可见神经肌肉动作电位 (MAP)提早出现 ,成纤维细胞和胶原形成较对照侧减少 ;运动神经传导速度 (MNCV)加快 ;早期再生有髓神经纤维数目增加和有髓神经纤维直径增粗 ,较对照侧差别有显著性意义 (P<0 .0 1)。　结论　 t- PA可促使早期神经挤压伤处血栓和纤维蛋白的降解 ,在周围神经再生微环境中具有一定的作用 ,有利于大鼠挤压伤坐骨神经再生。Objectives To observe the effect of t PA on the repair of crushed rat sciatic nerve and explore the function of t PA in the microenvironment of peripheral nerve regeneration, Methods Thirty six Wistar rats were explored The bilateral sciatic nerves were used in the experimental study The left one was the testing side, and the right one was the control After the sciatic nerves were crushed, 2 μm t PA(5 μg) or 2 μm normal saline were injected into the crushed site respectively The general observation,electrophysiological test, morphological examination and morphometry were performed after 14,28, 56 days surgery Results At the 14th day, the fibroblasts and collagenation decreased in the left side, in the main time, the evoked muscle action potential (MAP) appeared earlier in the t PA treated side than in the control The motor nerve conductive velocity of the side,Morphometrically, more regenerated t PA treated side was significantly faster than that of the control myelinated fibers with larger diameters were demonstrated in the t PA treated sides Conclusions The t PA can promote the fibrin degeneration and thrombolysis in the crushed site of sciatic nerve in the early stage, and play certain roles in the microenvironment of peripheral nerve regeneration The t PA can facilitate the rat crushed nerve regeneration

关 键 词：坐骨神经再生 神经挤压伤 纤溶酶原激活剂 

分 类 号：R363[医药卫生—病理学]