硫酸软骨素酶处理的异体去细胞神经修复周围神经缺损的实验研究  

Decellularized nerve allograft treated with chondroitinase ABC for repair of peripheral nerve defects： an experimental study

作　　者：蒋良福[1] 陈鸥[1] 褚庭纲[1] 丁健[1] 虞庆[1] 张国佑[1] 李志杰[1] 

机构地区：[1]温州医学院附属第二医院手外科,325027

出　　处：《中华手外科杂志》2013年第4期208-211,共4页Chinese Journal of Hand Surgery

基　　金：浙江省自然科学基金项目（Y2100253）

摘　　要：目的评价应用硫酸软骨素酶ABC降解硫酸软骨素蛋白多糖的去细胞异体神经修复神经缺损的效果。方法经硫酸软骨素酶ABC处理后化学去细胞异体神经修复大鼠15mm坐骨神经缺损为实验组（A组），对照组为未经酶处理的化学去细胞异体神经移植组（B组）和自体神经移植组（c组）。术后8、12周进行痛觉刺激试验。术后12周进行肌电图检查，检测小腿三头肌湿重和有髓神经纤维密度，评价其修复周围神经缺损的效果。结果术后8周，A组痛觉恢复率高于B、C组。术后12周A、C组痛觉均恢复，B组部分大鼠痛觉恢复。术后12周，A、C组小腿三头肌湿重差异无统计学意义，移植段神经5mm处有髓神经纤维密度A组高于C组，移植段神经10mm处有髓神经纤维密度差异无统计学意义，移植段神经以远5min处胫神经平面有髓神经纤维密度A组略低于C组。肌电图动作电位波幅A组和C组无明显差别。神经传导速度A组低于C组。A、C组上述指标均优于B组。结论经硫酸软骨素酶ABC处理的去细胞神经，有利于轴突进入生长，缩短靶器官神经重新支配时间，提高修复效果。Objective To evaluate the effect of chondrotinase ABC treated decelluarilzed nerve allograft on repairing never defects in rats. Methods Nerve allografts were treated with chondrotinase ABC and decellurized using chemical detergents. The allografts were employed to repair 15 mm sciatic nerve defects in rats in the experiment group （Group A）. The nerve gaps were bridged by decellularized nerve without chondrotinase ABC treatment in Group B and by autografts in Group C. Pain reaction was tested at 8 weeks and 12 weeks postoperatively. Eleetrophysiology, muscle wet weight of the gastroenemius-soleus complex and the mye//nated fiber density of the regenerated nerve were quantified at 12 weeks postoperatively. Results The proportion of pain reaction recovery in Group A was higher than that in Group B and Group C at 8 weeks postoperatively. At 12 weeks postoperatively, pain reaction test was positive in all the rats in Group A and Group C, whereas most of but not all the rats in Group B had a positive pain reaction. There was no significant difference in muscle weight of rats in Group A and Group C at 12 weeks. The myelinated nerve fiber density at the proximal 5 mm of the graft was higher in Group A than in Group C, whereas no significant difference was seen at the distal 10 mm of the graft. The myelinated nerve fiber density was slight lower in Group A than in Group C in the tibial nerve division 5 mm distal to the graft. Compound muscle action potential amplitude showed no differences between group A and group C. Nerve conduction velocity was slower in Group A than in Group C. The aforementioned indexes in Group B were inferior to Group A and Group C. Conclusion Chondrotinase ABC treatment facilitates axons to enter the decelluarilzed nerve allograft. This reduces target organ reinnervation time and improves functional recoverv.

关 键 词：神经再生 硫酸软骨素 硫酸软骨素蛋白多糖 去细胞神经 

分 类 号：R651.3[医药卫生—外科学]