腱止点过度使用性损伤组织:形态学及生长因子的变化  

Overuse-induced patella-patellar tendon junction injuries: histological characteristics and growth factor expression levels

作　　者：梁孝天 曾晓辉[1] 王博[1,2] 唐旖旎[1] 郝智腾 王琳[2] 

机构地区：[1]北京体育大学运动康复系,北京市100084 [2]北京体育大学运动医学教研室,北京市100084

出　　处：《中国组织工程研究》2017年第8期1251-1256,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金课题(30871209)~~

摘　　要：背景:髌骨髌腱结合部过度使用性损伤十分常见,目前学术界对该病的发病及愈合机制尚不清楚。目的:拟通过对髌腱止点处进行反复牵拉建立过度使用性损伤动物模型,从组织形态学及生长因子变化角度探讨过度使用性损伤及愈合的机制。方法:28只新西兰大白兔随机分为4组,空白对照组4只,左右后肢均作为对照;损伤造模组、自然愈合组和低强度干预组各8只,左后肢进行循环载荷训练。损伤造模组训练4周后立即处死;自然愈合组训练4周后继续休息4周处死;低强度干预组训练4周后改换低强度继续训练4周;对照组不做任何处理。观察循环载荷训练对兔髌骨髌腱结合部损伤形成及愈合过程中组织形态学、生长因子表达量的影响。结果与结论:(1)与空白对照组相比,损伤造模组细胞排列紊乱,潮线消失,胶原纤维波浪状结构消失;自然愈合组及低强度干预组织学形态虽未能恢复正常但较损伤造模组更好;(2)3个实验组的纤维软骨带厚度及碱性成纤维细胞生长因子均显著高于空白对照组(P<0.05);损伤造模组细胞浓度及血管内皮生长因子明显高于空白对照组和自然愈合组(P<0.05);(3)结果表明,髌骨髌腱结合部过度使用性损伤造模成功后,休息4周仍不能恢复到正常状态,而伤后进行低强度训练有利于改善愈合质量。BACKGROUND： Although overuse-induced patella-patellar tendon junction injury is a common disease, its pathogenesis and healing mechanism remain unclear.OBJECTIVE： To establish an overuse-induced injury animal model by a repetitive traction at the patellar tendon insertion,and to explore its pathogenesis and healing mechanism based on histomorphology and growth factor expression levels.METHODS： Twenty-eight New Zealand rabbits were randomly divided into four groups： the rabbit left and right posterior limbs without any intervention as controls （n=4）; cyclic loading training targeting the left posterior limb was done in model,healing and training groups （n=8 per group） for 4 weeks. Afterwards, the rabbits in the model group were killed immediately, rabbits in the healing group relaxed for another 4 weeks and then were killed, while rabbits in the training group were subjected to 4-week low-intensity training. The histological changes and growth factor expression levels during patella-patellar tendon junction injury and healing after load training were observed.RESULTS AND CONCLUSION： Compared with the control group, in the model group, the cells and collagenous fibers arranged in disorder, and the tidemark disappeared. The healing and training groups healed incompletely, but showed better histological changes than the model group. The thickness of fibrocartilage and basic fibroblast growth factor level in the control group were significantly lower than those in the other three groups （P 〈 0.05）. The cell density and vascular endothelial growth factor level in the model group were significantly higher than those in the control and healing groups （P 〈 0.05）. These results show that the animal model of overuse-induced patella-patellar tendon junction injury cannot return to normal after 4 weeks of rest, but the low-intensity training is conductive to healing quality.

关 键 词：累积创伤 成纤维细胞生长因子 血管内皮生长因子类 组织工程 组织构建 过度使用性损伤 髌腱止点 愈合 碱性成纤维细胞生长因子 血管内皮生长因子 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]