急性损伤后开始训练时间对髌骨髌腱结合部愈合的影响  

Effect of different resting time on patella-patellar tendon healing after acute injury

作　　者：梁孝天 王博[1] 曾晓辉[1] 唐旖旎[1] 肖芳欣 李海伟[2] 王琳[3] 

机构地区：[1]北京体育大学,北京市100084 [2]山西师范大学体育学院,山西省临汾市041000 [3]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12期1805-1812,共8页Chinese Journal of Tissue Engineering Research

基　　金：教育部科技发展项目;博士点基金课题(20111112110005);课题名称:伤后开始训练时间对骨腱结合部急性损伤修复的影响及其作用机理研究~~

摘　　要：背景:髌骨髌腱结合部损伤在运动训练中十分常见且复发率较高,及时合理的恢复训练对保持竞技状态有利,而不恰当的恢复训练则有可能加重损伤。目的:从组织形态学、生长因子、胶原蛋白表达量及肌张力等角度,探讨伤后休息不同天数恢复训练对骨腱结合部愈合质量的影响。方法:40只新西兰大白兔被随机分为:空白对照组,针刺后分别休息24,48,72,96,120 h开始恢复训练组。除空白对照组外,其余各组于髌腱止点处进行针刺损伤造模后采用已建立的循环载荷训练模型,进行4周低强度训练后处死取材,行组织学苏木精-伊红、番红及免疫组织化学染色;每次训练后利用Myoton-3肌肉功能分析仪采集肌张力,肌肉硬度数据;Metamorph图形处理软件对各组纤维软骨带厚度、细胞密度,血管内皮生长因子、胶原阳性染色细胞密度进行定量计算。结果与结论:(1)与空白对照组相比,各伤后训练组在呈现出不同程度的组织形态改变,包括胶原排列紊乱,细胞密度降低,黏多糖蛋白增多,出现"涨潮"现象等;(2)针刺后24 h与针刺后120 h组纤维软骨带厚度比空白对照组显著增厚(P<0.05);(3)针刺后24 h组与针刺后48 h组的Ⅰ型胶原与Ⅲ型胶原比例显著低于空白对照组(P<0.05),72 h组最高;(4)针刺后48 h,针刺后72 h与针刺后96 h组的血管内皮生长因子表达量相较于空白对照组显著增高(P<0.05);(5)肌张力与胶原比例(r=-0.538;P<0.01)及软骨细胞密度(r=-0.570;P<0.01)呈负相关关系,而肌肉硬度则与血管内皮生长因子表达量呈正相关关系(r=0.613;P<0.01);(6)结果说明,急性损伤后不同开始恢复训练时间会对髌骨髌腱结合部的愈合造成明显的差异,伤后休息72 h开始训练是最为合理的选择;研究证实了肌张力及肌肉硬度会对细胞密度,胶原合成及生长因子表达存在相关性,此指标测量方便且无创,可应用在伤后训练及预防损伤复发等�BACKGROUND：Patella-patellar tendon junction （PPTJ） injuries are a common disease in athletes and vulnerable to re-injury. Post-injury training is a double-edged sword. OBJECTIVE：To examine the effect of post-injury resting days on the quality of healing in PPTJ in view of histomorphology, expression levels of growth factor and collagen, and muscle tension. METHODS：Forty New Zealand white rabbits were randomly divided into control, and five post-injury training groups representing different time to restart training after acute injury：the rabbits restarted training at 24 （PIT24）, 48 （PIT48）, 72 （PIT72）, 96 （PIT96） and 120 （PIT120） hours, respectively. All post-injury training groups received acupuncture at the PPTJ and then underwent 4-week low-intensity training. Afterwards, all rabbits were killed to take specimens for hematoxylin-eosin, safranin O and immuohistochemical staining. The muscle tension and hardness were detected using Myoton-3. The thickness of fibrous cartilage zones, cell density, as well as the expression levels of vascular endothelial growth factor and collagen were measured on Metamorph software. RESULTS AND CONCLUSION：Compared with the control group, in the PIT groups, the collagens arranged in disorder, and decreased cell density, increased mucopolysaccharide and＂rising tide＂phenomenon appeared. The fibrocartilage in the PIT24 and PIT120 groups was significantly thicker than that in the control group （P〈0.05）. The ratio of collagen type Ⅰ/Ⅲ was significantly decreased in the PIT24 and PIT48 groups compared with the control group （P〈0.05）, and the highest in the PIT72 group. The expression level of vascular endothelial growth factor in the PIT48, PIT72 and PIT96 groups was significantly higher than that in the control group （P〈0.05）. The muscle tension was negatively correlated with the collagen ratio （r=-0.538;P〈0.01） and chondrocyte density （r=-0.570;P〈0.01）, while muscle hardness was positively correlated with the expre

关 键 词：组织构建 组织工程 髌骨髌腱结合部 伤后训练 急性损伤 愈合 肌肉特性 

分 类 号：R318[医药卫生—生物医学工程]