同种异体软骨修复甲状软骨缺损的实验研究  

Experimental study on laryngeal cartilage defects repair with differently preserved allogeneic cartilages tranplantation

作　　者：赵大庆[1] 陈文弦[1] 李贵泽[1] 孙永柱[1] 孙安[1] 

机构地区：[1]第四军医大学唐都医院耳鼻咽喉科,西安710038

出　　处：《中华耳鼻咽喉科杂志》2002年第2期112-114,共3页Chinese Journal of Otorhinolaryngology

摘　　要：目的　观察用不同类型的同种异体软骨修复喉软骨缺损的效果。方法　取新西兰白兔16只 ,平均分成两组。在每只兔的双侧甲状软骨切除 6mm× 3mm× 1mm全层软骨。一组动物将RPMI 16 4 0液和甲醛保存 30d的同种异体甲状软骨 (大小为 5mm× 2mm× 1mm)分别植入甲状软骨两侧缺损处 ,另一组动物于甲状软骨两侧缺损处分别植入新鲜的自体和异体软骨。分别于术后 7、30、180及 36 0d时处死取材 ,用大体观察、HE染色及免疫组织化学方法观察移植修复效果。结果经连续 1年观察 ,RPMI 16 4 0液保存的及新鲜的同种异体软骨与自体软骨移植排斥反应轻 ,均能较好修复甲状软骨缺损 ,而甲醛保存软骨早期有明显炎性细胞浸润 ,移植 180d至 36 0d时软骨基质明显吸收 ,软骨细胞退变 ,甲状软骨缺损区为纤维结缔组织修复。结论　RPMI 16 4 0液保存的及新鲜的同种异体软骨都具有活性 ,和自体软骨一样是软骨缺损修复的良好材料 。Objective To study the effect of laryngeal cartilage defect repair with differently preserved allogeneic cartilage grafts Methods 16 New Zealand white rabbits were used and divided into two groups A 6 mm×3 mm×1 mm whole thickness cartilage defect was made in each side of the thyroid cartilage of each rabbit In group one, the tissue cultured cartilage grafts, preserved in RPMI 1640 medium for 30 days, were implanted in the left defects and the 4% formaldehyde preserved cartilage grafts for 30 days were implanted in the right defects Fresh autogenous and allogeneic grafts were seprately transplanted into the right and left thyroid cartilage defects of the other group Thyroid cartilages were taken out at 7?30?180 and 360 days after implantation Samples were observed by macroscopy and prepared for hematoxylin and eosin (H&E) staining and immunohistochemical examination Results No marked changes in form and volume were found in the fresh allografts and RPMI 1640 cultured cartilage grafts The same as the autogenous cartilages,the defects of thyroid cartilage were successfully repaired by the fresh allografts and RPMI 1640 cultured cartilages Whereas 4% formaldehyde preserved cartilage grafts were completely absorbed and replaced by cicatricial tissues in the thyroid cartilage defects Histological observation showed that severe inflammatory cellular infiltration in the formaldehyde preserved cartilages at 7 and 30 days The cartilage matrixes were resorpted and the chondrocytes showed degenerative change Finally they were replaced by fibrous connective tissue at 360 days In the RPMI 1640 cultured and fresh allogeneic cartilages only a little inflammatory cellular infiltration was observed and the cartilage matrixes were almost normal from 7 to 360 days Conclusion It is clinically feasible to use allogeneic grafts stored in RPMI 1640 medium or fresh allogeneic cartilage grafts for repairing laryngeal cartilage defects

关 键 词：软骨 组织培养 同种移植 甲状软骨缺损 喉软骨缺损 

分 类 号：R767.91[医药卫生—耳鼻咽喉科] R767.3[医药卫生—临床医学]