兔同种异体新鲜半月板移植后组织学变化  

Macroscopic and Histological Evaluations of Allogeneic Fresh Meniscus Transplantation in Rabbits

作　　者：杨渝平[1] 张继英[1] 段小宁[1] 胡晓青[1] 孟庆阳[1] 刘振龙[1] 史尉利 敖英芳[1] Yang Yuping Zhang Jiying Duan Xiaoning Hu Xiaoqing Meng Qingyang Liu Zhenlong Shi Weili Ao Yingfang(Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China)

机构地区：[1]北京大学第三医院运动医学研究所,北京100191

出　　处：《中国运动医学杂志》2016年第12期1125-1131,共7页Chinese Journal of Sports Medicine

摘　　要：目的:探讨兔同种异体新鲜半月板移植后,移植物形态结构的组织学衍变过程。方法:成年新西兰大白兔12只,分为3组:6周组、12周组和24周组,每组4只。每次2只兔同时接受手术,将2只兔实验侧的内侧半月板互换,进行同种异体新鲜内侧半月板移植。术后6周、12周、24周处死,观察大体半月板愈合情况,并行HE染色、天狼星红染色等组织学检查。结果:术后6周半月板移植物与周围组织愈合情况良好,但存在明显异物反应表现。12周和24周时,每组各有50%的半月板出现肉眼可见的明显皱缩,镜下可见基质松散。HE染色显示3组均存在血管增生、纤维化和淋巴细胞浸润等表现。天狼星红染色显示:6周组75%的标本Ⅲ型胶原占比少于1/3;12周组50%的标本Ⅲ型胶原占比介于1/3和2/3之间;24周组全部标本Ⅲ型胶原占比均超过2/3。6周组有25%出现胶原纤维少量松散;12周组100%出现少量松散,且主要位于中心区;24周组50%出现大量松散,而且这种松散的表现扩展到整个半月板区域。三组间差异均有统计学意义(P<0.05)。结论:兔同种异体新鲜半月板移植术后6周愈合良好,但存在明显异物反应表现,12周和24周部分移植物会出现明显肉眼可见的皱缩和镜下可见的基质松散现象。而且随着时间推移,内部胶原纤维从Ⅰ型胶原为主逐渐转变为Ⅲ型胶原为主。这种变化先从中心区开始,范围逐渐扩大,使移植物的结缔组织结构逐渐弱化,可能最终导致移植物的失效。Objective To investigate the morphological transmutation of the allogeneic fresh meniscus transplantation in rabbits. Methods Twelve adult New Zealand white rabbits were divided into 3 groups according to the time they were executed after transplantation：6 weeks, 12 weeks and 24 weeks,each of 4. Every two rabbits underwent surgery at the same time to exchange the medial meniscus on the experimental side. The allogeneic fresh medial meniscus transplantation was thus performed. Then they were killed to get the meniscus. The healing of the meniscus was observed and histological examina- tion was conducted using HE staining and Sirius red staining. Results Six weeks after the transplanta- tion,the transplanted meniscus and its surrounding issues healed well. In both the 12-week and the 24-week groups, 50% of the menisci showed visible shrinkage and matrix loose. There were foreign body reactions in all 3 groups, such as vascular proliferation, fibrosis and lymphocyte infiltration. Sirius red staining demonstrated that,in the 6-week-group type Ⅲ collagen accounted for less than one third in 75% of the specimens; it accounted for between one-third and two-thirds in 50% of the specimens in the 12-week-group;in the 24-week-group,it occupied two thirds. Twenty-five percent of the colla- gen in the 6-week-group had a small amount of collagen fiber loose;in the 12-week-group,all had a formed gradually from type Ⅰ collagen to type Ⅲ collagen. The change starts from the central region, expanding gradually. Subsequently it weakens connective tissue structure of the graft and may ultimate- ly lead to transplantation failure.

关 键 词：同种异体半月板 移植 胶原 组织学 

分 类 号：R687.4[医药卫生—骨科学]