人工神经桥接体修复神经缺损的研究  

Study of artificial nerve to restore the nerve defect

作　　者：徐伟[1] 肖玉周[1] 代秀松[1] 师佩兰[1] 

机构地区：[1]蚌埠医学院第一附属医院骨科组织移植安徽省重点实验室,蚌埠233004

出　　处：《南通大学学报（医学版）》2012年第5期363-368,共6页Journal of Nantong University(Medical sciences)

基　　金：安徽省高教委自然科学基金资助项目(2005KJ283)

摘　　要：目的:观察冷冻处理后的兔胚胎施万细胞(Schwann cells,SCs)种植到去细胞基膜管中移植对周围神经缺损再生的影响,寻求修复周围神经缺损较为理想的方法。方法:取成年雄性兔88只,建立左侧上臂正中神经20 mm缺损模型,随机分为4组,每组22只,分A组:自体神经移植组,B组:去细胞基膜管桥接体组,C组:去细胞基膜管种植未冷冻处理胎兔SCs的桥接体组,D组:去细胞基膜管种植两步冷冻处理胎兔SCs的桥接体组,4组修复兔正中神经缺损。于16周内不同时间段行大体观察,光、电镜组织学观察及形态定量学分析(再生有髓神经纤维密度、髓鞘平均厚度、有髓纤维直径),检查各组桥接体运动神经传导速度,称指浅屈肌肌肉湿质量;术后8周行辣根过氧化物酶(horseradish peroxi-dase,HRP)逆行示踪标记,观察神经功能恢复。结果:C组和D组神经再生及功能指标(再生有髓神经纤维密度、髓鞘平均厚度、有髓纤维直径、运动神经传导速度、肌肉湿质量恢复率)与A组比较,差异无统计学意义(P>0.05)。6周时C组存在单核细胞浸润情况较D组严重,胶原纤维形成稍多。8周行HRP逆行示踪标记,A、B、C、D 4组背根神经节和脊髓前角运动神经元均可见深蓝色或蓝黑色阳性细胞,B组阳性细胞数(5.00±2.16)个与其他3组比较差异有统计学意义(P<0.05),D组(12.5±3.87)个﹑C组(11.75±2.16)个与A组(13.50±4.20)个比较差异无统计学意义(P>0.05)。结论:采用两步冷冻法处理后的兔胚胎SCs种植到去细胞基膜管中制备人工神经桥接体,经培养后桥接修复兔正中神经缺损能提高神经再生质量,很少发生免疫排斥反应,为神经修复提供了一种新方法。Objective： To investigate the effect of cryopreserved embryonic Schwann cells and acellular nerve basal lamina tubes transplantation on peripheral nerve regeneration.To seek a new method for repairing injured nerves.Methods： Eighty-eight adult male rabbits were equally divided into 4 groups and the models of injured Median nerve with 20 mm gap were made.Median nerve defects were repaired in each group.The autologous nerve grafts,acellular nerve basal lamina tubes,bridges consisted of acellular nerve basal lamina tubes and neonatal Schwann cells,bridges consisted of acellular nerve basal lamina tubes and cryopreserved embryonic Schwann cells were used in group A,B,C and D respectively.At 6,12,16 weeks postoperatively,the regeneration of nerve were observed through general observation,histilogical examination,morphologic analysis（including the density of regenerative myelinated fibers,diameter of myelinated fibers,thickness of myelins）,electrophysiological test and muscle wet weight recovery rate.At 8 weeks,the horseradish peroxidase（HRP） tracing were used to detect the nerve functional recovery.Results： The parameters of neural regeneration and functions（including the density of regenerative myelinated fibers,diameter of myelinated fibers,thickness of myelins,the motor nerve conduction velocity and muscle wet weight） in group D and C were nonsignificant in comparison with group A（P0.05）.Lymphomonocytes infiltration and the collagens formation of group C were more than that of group D at 6 weeks.The HRP labled masccline neurons of dorsal root ganglion and spinal ventral horn in group B were significant in comparison with group A,C,D at 8 weeks（P0.05）,but there were nonsignificant in group A,C and D（P0.05）.Conclusion： The nerve bridges composed of cryopreserved embryonic Schwann cells and acellular nerve basal lamina tubes with tissue engineering methods could restore the nerve defects and improve the quality of regenerated nerves,which offered a new method for repairing injured nerve

关 键 词：周围神经损伤 组织工程 去细胞基膜管 施万细胞 

分 类 号：R745[医药卫生—神经病学与精神病学]