组织工程化人工神经修复长段神经缺损实验的初步报告  

Repair of a long nerve defect with a tissue engineered bioartificial nerve graft: a preliminary report

作　　者：沈尊理[1] Berger Alfred Hierner Robert Lohmeyer Joern Allmeling Christina Walter F.Gerhard 

机构地区：[1]上海市第一人民医院整形外科,200080 [2]Clinic of Plastic,Hand and Reconstructive Surgery,Hannover MedicalSchool [3]Institute of europathology

出　　处：《中华手外科杂志》2001年第2期112-115,共4页Chinese Journal of Hand Surgery

基　　金：德中-中德医学友好协会;德国汉诺威医学院友好协会联合资助

摘　　要：目的　研究组织工程化人工神经修复大鼠 2 .5cm长坐骨神经缺损的效果。方法　 90只 2个月月龄的Lewis 1W雌性大鼠 ,按手术先后顺序随机分成 3个神经移植组 ,每组 3 0只。A组 :用种植同源雪旺细胞并具有内部支架结构的胶原神经管桥接 ,即组织工程化人工神经组。B组 :用无雪旺细胞但具有内部支架结构的胶原神经管桥接 ,即对照组。C组 :自体神经移植组。术后 6个月 ,进行神经电生理监测 ,神经肌肉组织学观察 ;用S 10 0和神经微丝蛋白免疫组化染色后 ,行轴突计数等检测。结果　完成对 2 1只大鼠 (每组 7只 )的实验评估。从A组和C组的胫前肌中均能诱发出波幅明显的神经肌肉复合动作电位 (CMAP) ,再生轴突已通过移植段神经全长 ,远端肌肉轻度萎缩。B组中则没有或仅记录到波幅很低的CMAP ,移植神经远端结缔纤维组织增生 ,再生轴突罕见 ,所支配肌肉明显萎缩。结论　组织工程化人工神经可用来修复大鼠长段神经缺损。Objective To evaluate the effectiveness of a tissue engineered artificial nerve on bridging sciatic nerve defect 2.5 cm in length in rats. Methods 90 female Lewis 1W rats aged 2 months were randomly divided into three groups, with 30 in each. Three types of materials were used as graft: group A, collagen nerve tubes with an intrinsic framework seeded with syngeneic Schwann cells, which were referred as tissue engineered artificial nerves; group B, collagen nerve tubes filled with an intrinsic framework without Schwann cells; and group C, nerve autografts. Six months later, a series of examinations were performed as follows: electrophysiological testing, hisotological staining of nerves and muscles, S 100 and neurofilament immunostaining as well as axon counts.Results Until now, the assessment has been finished in 21 rats (7 rats in each group). A significant compound muscle action potential (CMAP) was evoked in anterior tibial muscle in group A and C. Regenerated axons were observed in the whole length of nerve grafts, with mild atrophy of their innervating muscles. On the contrary, nothing or only a tiny CMAP was recorded in group B. The distal parts of nerve grafts were filled with fibrotic tissue, while regenerated axons were rarely seen. There was a significant atrophy of the related muscles. Conclusions Our preliminary results demonstrated that the tissue engineered artificial nerve could effectively repair a long nerve defect in rats.

关 键 词：神经移植 许旺氏细胞 细胞培养 组织工程 

分 类 号：R651.3[医药卫生—外科学]