自组装多肽与神经生长因子导管修复兔周围神经缺损  

Self-assembly peptide and nerve conduit combined with nerve growth factor for repair of peripheral nerve defect in rabbit

作　　者：张伟[1] 刘俊健[2] 王季[1] 李明[3] 傅强[3] ZHANG Wei;LIU Jun-jian;WANG Ji(Department of Orthopedics, The 401^st Hospital of PLA, Qingdao 266071, China)

机构地区：[1]解放军第401医院,山东青岛266071 [2]同济大学附属第十人民医院骨科,上海200433 [3]第二军医大学长海医院骨科,上海200433

出　　处：《中国矫形外科杂志》2018年第8期751-756,共6页Orthopedic Journal of China

基　　金：济南军区后勤科研计划项目(编号:JN13W019)

摘　　要：[目的]探索自组装多肽凝胶复合神经生长因子(NGF)的神经导管修复周围神经损伤的可行性及效果。[方法]以静电纺丝技术制备单纯聚乳酸-羟基乙酸(PLGA)和PLGA复合NGF的纳米纤维复合神经导管,制备"异亮氨酸-赖氨酸-缬氨酸-丙氨酸-缬氨酸"(IKVAV)顺序的自组装多肽凝胶。选取新西兰大白兔72只,制备兔坐骨神经10 mm缺损模型。按随机数字法分为4组,每组18只,分别给予以下处理:A组自体神经移植,B组单纯PLGA神经导管+NGF桥接,C组单纯PLGA神经导管+IKVAV多肽凝胶+NGF桥接、D组复合NGF的PLGA导管+IKVAV多肽凝胶桥接。术后1、2、3个月行电生理检测、大体观察、小腿三头肌湿重恢复率测量和组织学检查。[结果]术后复合NGF导管逐渐吸水膨胀并降解,周围组织未见明显炎性反应,无神经卡压。术后1个月,再生神经已通过缺损,但直径细小,随着时间延长逐渐增粗。各组间比较发现,D组神经再生效果接近A组,各项指标优于B组(P<0.05),部分指标优于C组(P<0.05)。D组和A组之间比较,差异无统计学意义(P>0.05),但小腿三头肌湿重恢复率较A组稍差。[结论]自组装多肽凝胶联合复合神经生长因子的神经导管具有良好的组织相容性,能够有效促进神经生长,效果接近自体神经移植。[Objective] To explore the feasibility and efficiency of self-assembled peptide and nerve conduit combined with nerve growth factor for repair of peripheral nerve defect in rabbit. [Methods] The pure poly（lactic-co-glycolic acid）（PLGA）,and combined with nerve growth factor conduits were prepared using electrostatic spinning technology. In addition, self-assembled peptide in sequences of（isoleucine-lysine-valine-alanine-valine, IKVAV） was also get ready. A 10 mm nerve defect model was created in the sciatic nerves of 72 New Zealand rabbits, which were randomly divided into 4 groups with 18 animals in each group. In term of the methods of defect repaired, the group A had the defect repaired with nerve autograft, while the group B had the defect bridged with PLGA conduit ＋NGF, the group C with PLGA conduit ＋IKVAV ＋NGF, and the group D with PLGA combined with NGF conduit ＋ IKVAV. The EMG check, gross observation, wet weight of triceps surae, and histological assessment were conducted at 1, 2 and 3 months after operation. [Results] Nerve conduit combined with nerve growth factor was gradually expanded and degraded, without obvious inflammatory reaction in the surrounding tissues and nerve compression.At 1 month after operation, the regenerated nerve fibers had passed through the defect area with a shrunk diameter in all groups.The defect area was gradually thickening over time. Compared among the 4 group, the group D was close to the group A, superior to the group B in all parameters（P〈0.05）, whereas better than the group C in some parameters of nerve regeneration（P〈0.05）. There were no significant differences between the group D and group A in most parameters（P〈0.05）, despite the fact that the wet weight of triceps surae in group D was slightly lighter than that in the group A. [Conclusion] For repairing nerve de-fect in this animal model, the PLGA-nerve growth factor composited nerve conduit added with self-assembled peptide gel does achieve satisfactory outcome close to that of

关 键 词：自组装多肽 神经导管 周围神经 神经生长因子 神经再生 

分 类 号：R318[医药卫生—生物医学工程]