喉外伤后声门旁注射肝细胞生长因子预防声带瘢痕形成的实验研究  

Prevention of vocal fold scarring by paraglottic injection of hepatocyte growth factor after laryngeal trauma

作　　者：潘叶挺[1] 邹坚定[1] 龚梁[1] 陈建强[1] 徐建群[1] 

机构地区：[1]温州医学院附属慈溪医院耳鼻咽喉科,315300

出　　处：《中国中西医结合耳鼻咽喉科杂志》2013年第4期249-254,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：浙江省医药卫生科技计划项目(2011KYA145);宁波市自然科学基金(2010A610068)

摘　　要：目的观察兔声带外伤局部注射肝细胞生长因子（hepatocyte growth factor，HGF）后组织病理学、增殖细胞抗原（proliferating cell nuclear antigen, PCNA）及主要细胞外基质（extracellular matrix，ECM）的变化特点。方法对40只实验用兔80侧声带进行锐性损伤，将兔随机分为治疗组和创伤组，另随机选5只试验兔作为对照组。治疗组于损伤后即刻在声门旁注射HGF，创伤组则注射生理盐水。损伤后1周～6个月时采用HE染色、免疫组化染色、ELISA测定及Masson染色法，观察声带组织学结构变化、PCNA及固有层内透明质酸（hyaluronic acid, HA）、胶原纤维等主要ECM的分布及含量变化。结果创伤组声带损伤3个月后局部开始出现瘢痕挛缩，以胶原纤维为主的大量纤维组织增生，6个月时仍紊乱分布于声带固有层各层，损伤后3个月内 PCNA增强（P〈0.05），6个月内胶原纤维含量明显高于正常对照组（P〈0.05），HA增加不明显。治疗组6个月时形态接近正常，早期的HA、PCNA的表达明显高于创伤组（P〈0.05），中、后期差异性消失，胶原纤维含量在3月内有增高趋势，其后稳定，但总体水平均明显低于创伤组（P〈0.05）。结论声门旁注射HGF后具有促进声带ECM分泌、合理分布及部分有序化排列的功能，具有促进声带修复再生的作用。Objective To investigate the treatment for injured vocal folds in rabbit models by injecting hepatocyte growth factor （HGF）, and to observe the characteristics of histopathology, the proliferative activity of epithelial cell and the major extra cellular matrix（ECM）. Methods The lamina propria was injured by localized resection in 80 vocal folds of 40 rabbits. The rabbits were randomly divided into two groups, the treatment group and the trauma group. As control, five rabbits were selected additionally. The HGF and isotonic sodium chloride solution were injected into paraglottic tissue immediately after the injury procedure. Laryngeal bodies were harvested at 1 week and 1, 3, 6 months after operation respectively. HE staining was performed for histopathologic research, immunohistochemical staining for the proliferative activity of epithelial cell, enzyme-linked immunosorbent assay （ELISA） for hyaluronic acid, and masson trichrome staining for collagen fibers. Results In the trauma group, vocal fold showed a local scar contracture at third month after injury, histology showed large number of fibrous tissue （mainly collagen fibers） hyperplasia with a tendency of increasing, disorders was also found in vocal fold lamina propria at Sixth month. The proliferative activity of epithelial cell increased in 3 months （P〈0.05）, collagen fibers were significantly higher than normal （P〈0.05） in 6 months, however, hyaluronic acid had less increase. In the treatment group, the morphology and histologic structure of vocal folds were similar to normal after six months. The expression of HA and PCNA in the treatment group were significantly higher than that in the trauma group at early stage and the difference disappeared at middle and late stage. Collagen fibers had an increasing trend in three months, had a stable level subsequently, and were significantly lower than the trauma group. Conclusion part ordering arrangement. It also plays an important role in vocal folds reparation and regeneration.

关 键 词：声带瘢痕 细胞外基质 肝细胞生长因子 

分 类 号：R767[医药卫生—耳鼻咽喉科]