脱细胞肌腱片促进兔肩袖损伤腱-骨愈合的实验研究  

ROTATOR CUFF REPAIR WITH DECELLULARIZED TENDON SLICES FOR ENHANCING TENDON-BONE HEALING IN RABBITS

作　　者：潘娟[1,2] 刘国明[3] 宁良菊[4] 罗静聪[4,5] 黄富国[3] 秦廷武[4,5] 

机构地区：[1]四川大学华西医院康复医学科,成都610041 [2]四川大学华西医院康复医学四川省重点实验室,成都610041 [3]四川大学华西医院骨科,成都610041 [4]四川大学华西医院生物治疗国家重点实验室·干细胞与组织工程研究室,成都610041 [5]四川大学华西医院再生医学研究中心,成都610041

出　　处：《中国修复重建外科杂志》2013年第9期1070-1075,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家高技术研究发展计划(863)资助项目(2012AA020502);教育部留学回国人员科研启动基金资助项目(2010609)~~

摘　　要：目的评价犬脱细胞肌腱片(decellularized tendon slices,DTSs)对兔肩袖损伤腱-骨愈合的作用。方法取成年比格犬跟腱经反复冻融5次结合核酸酶处理12 h制备DTSs,体外对DTSs行组织学观察和细胞相容性评价。取成年雄性新西兰大白兔24只,体重2.5～3.0 kg,随机选取一侧肩关节自冈下肌腱止点处纵向作宽大于正常肌腱50%、长为8 mm的U形缺损,用犬DTSs修复冈下肌腱缺损并重建腱-骨止点(实验组);对侧肩关节不作任何处理(对照组)。术后4、8、12周取两组标本行组织学观察和生物力学测试。结果体外组织学观察示犬DTSs胶原结构保留完整,无细胞残留;细胞相容性实验示成纤维细胞与DTSs良好黏附。生物力学测试示,随时间延长,实验组最大载荷和刚度均呈增加趋势,12周时显著高于4周及8周(P<0.05);除12周实验组最大载荷与对照组比较差异无统计学意义(t=0.969,P=0.361)外,其余各时间点实验组最大载荷及刚度均显著小于对照组(P<0.05)。组织学观察示,对照组可见腱-骨止点的4层结构。实验组术后4周腱-骨界面由肉芽组织填充,少量类似Sharpey纤维连接于腱-骨间;随时间延长肉芽组织界面消失,成纤维细胞、Sharpey纤维、新生软骨和软骨细胞数量增多,腱-骨界面逐渐成熟,但未见位于矿化纤维软骨与非矿化纤维软骨间的潮线。结论经反复冻融5次结合核酸酶处理12 h制备的犬DTSs可促进兔肩袖损伤腱-骨愈合,提高肩袖损伤修复的生物力学性能。Objective To investigate the effect of canine decellularized tendon slices （DTSs） on tendon-bone healing in repairing rotator cuff injury of rabbit. Methods Canine DTSs were prepared by repetitive freeze/thaw 5 times combined with nuclease processing for 12 hours from the adult Beagles Achilles tendons. Histological observation and cytocompatibility evaluation for the canine DTSs were performed in vitro. Twenty-four mature male New Zealand white rabbits, weighing 2.5-3.0 kg, were randomly selected. U-shaped defect of more than 50% of normal tendon in width and 8 mm in length was made in infraspinatus tendons of unilateral limb as the experimental group; the canine DTSs were used to repair defect, and the insertion of infraspinatus tendon on greater tuberosity of humerus was reconstructed in the experimental group. No treatment was done on the contralateral limb as the control group. At 4, 8, and 12 weeks after operation, the specimens were harvested for histological observation and biomechanical test. Results Histological examination showed that collagen fbers of canine DTSs were well preserved, without residual cells. The cytocompatibility examination showed that fibroblasts attached well to canine DTSs. Biomechanical test showed that the maximum load and stiffness increased significantly with time, and the maximum load and stiffness at 12 weeks were significantly higher than those at 4 and 8 weeks （P 〈 0.05）. The maximum load and stiffness of the experimental group at 4 and 8 weeks were significantly lower than those of the control group （P 〈 0.05）. The stiffness of the experimental group at 12 weeks was significantly lower than that of the control group （t= -5.679, P=0.000）, but no significant difference was found in the maximum load at 12 weeks between 2 groups （t=0.969, P=0.361）. Histological observation showed that the control group displayed a 4-layer structure of the tendon-bone insertion. In the experimental group at 4 weeks, the tendon-bone interface was filled with granulation t

关 键 词：脱细胞肌腱片 肩袖损伤 腱-骨愈合 犬 兔 

分 类 号：R687.4[医药卫生—骨科学]