脱细胞羊膜对兔同种异体跟腱移植后粘连的预防作用  

Human acellular amniotic membrane prevents tendon adhesion after allogenic tendon transplantation to repair Achilles＇ tendon defects in rabbits

作　　者：董瑞一[1] 赵红芳[1] 田德虎[1] 白江博[1] 于昆仑[1] 高鸣[1] 张国辉[1] 

机构地区：[1]河北医科大学附属第三医院手外科,石家庄050051

出　　处：《中华创伤骨科杂志》2013年第6期509-513,共5页Chinese Journal of Orthopaedic Trauma

基　　金：河北省卫生厅科研项目（20100102）

摘　　要：目的探讨脱细胞羊膜对兔同种异体跟腱移植后粘连的预防作用及其对跟腱愈合的影响。方法30只新西兰白兔随机分为2组（n=15）：实验组在移植跟腱处包裹羊膜，对照组在移植跟腱处不包裹羊膜。术后2、4周切取移植跟腱行组织学观察；术后2、4、6周取外周血行流式细胞学检测，取移植跟腱行大体观察和生物力学检测，并测定羟脯氨酸含量。结果术后2、4周组织学观察显示实验组炎性反应和浸润范围均较对照组局限，胶原纤维排列较对照组致密且整齐。术后2、4、6周实验组CD4^＋、CD8^＋T淋巴细胞计数及CD4^＋淋巴细胞与CD8^＋T淋巴细胞比值均低于对照组，实验细托断粘连带功耗小于对照组，跟腱最大拉伸断裂强度及羟脯氨酸含量均大于对照组，以上指标比较差异均有统计学意义（P〈0．05）。结论脱细胞羊膜可以有效颅防肌腱粘连，促进肌腱愈合，并有一定的抗免疫排斥作用。Objective To investigate the effect of human acellular amniotie membrane on tendon adhesion after allogenic tendon transplantation to repair Achilles＇ tendon defects in rabbits. Methods Thirty New Zealand white rabbits were randomly divided into 2 groups （ n = 15）. In the experimental group the transplanted Achilles＇ tendon was covered with human aeellular amniotic membrane while in the control group the transplanted Achilles＇ tendon was covered with nothing. The transplanted tissue samples were harvested at 2 and 4 weeks for histological observation. Peripheral blond samples were harvested for flow cytometry respeclively at 2, 4, and 6 weeks. The transplanted Achilles＇ tendons were harvested for gross observation, biomechauical tests and the hydroxyproline （Hyp） content determination at 2, 4, and 6 weeks after operation. Results The histological observation showed the inflammatory reaction in the experimental group was slighter than in the control group at 2 and 4 weeks and the arrangement of collagen fibers in the former was denser and more orderly than in the latter. The flow cytometry showed that at 2, 4, and 6 weeks the peripheral blood in the experimental group contained significantly fewer CD4 ^＋ and CD8^ ＋ T lymphocytes than in the control group, and the ratio of CD4^ ＋/CD8^ ＋T lymphocyte in the experimental group was significantly lower than in the control group （both P 〈 0. 05） . At 2, 4, and 6 weeks, the maximum tensile strength in the experimental group was significantly larger than in the contrul group, aud the tensile adhesion power consumption in the experimental group was significantly smaller than in the control group （both P 〈 0.05）. The Hyp content in the experimental group was significantly higher than in the control group （ P 〈 0.05） . Conclusions Human accllular amniotic membrane can prevent tendon adhesion, promote tendon healing and intensify strength effectively, and may suppress immunological rejection to a certain extent in the allogenic tendon

关 键 词：羊膜 跟腱 移植 同种 跟腱粘连 兔 

分 类 号：R687.2[医药卫生—骨科学]