自体注射型富血小板纤维蛋白联合BMSCs治疗大鼠坐骨神经损伤的实验研究  

Experimental study on autologous injectable platelets rich fibrin combined with bone mesenchymal stem cells in treating sciatic nerve injury in rats

作　　者：高海明 王波 曹家全 李秀军 黄陈翼 吴佳奇 刘宗超 GAO Haiming;WANG Bo;CAO Jiaquan;LI Xiujun;HUANG Chenyi;WU Jiaqi;LIU Zongchao(Department of Orthopedics,the Traditional Chinese Medicine Affiliated Hospital of Southwest Medical University,Luzhou Sichuan,646000,P.R.China)

机构地区：[1]西南医科大学附属中医医院骨科,四川泸州646000

出　　处：《中国修复重建外科杂志》2020年第5期637-642,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：四川省卫生健康委员会项目(130280)。

摘　　要：目的探讨自体注射型富血小板纤维蛋白(injectable platelet rich fibrin,i-PRF)联合BMSCs治疗大鼠坐骨神经损伤的疗效。方法取10~15日龄SD乳鼠胫骨骨髓分离培养BMSCs至第4代备用。取24只成年SD大鼠眶后静脉血采用改良低速离心法制备i-PRF后,采用改良挤压损伤法制作坐骨神经Ⅲ度损伤模型后随机分为4组,每组6只。A、B、C、D组分别于损伤部位鞘膜内注射BMSCs悬液+自体i-PRF、自体i-PRF、BMSCs悬液、生理盐水。术后1~8周每周采用BBB评分法评价大鼠患肢神经功能恢复情况;术后2个月处死各组大鼠取材,行HE染色观察坐骨神经组织结构变化,透射电镜观察神经纤维、髓鞘、细胞核等细微结构改变,Western blot检测N-cadherin、巢蛋白(Nestin)、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)表达。结果术后大鼠均未发生免疫排斥反应及死亡。术后1周各组大鼠BBB评分比较差异无统计学意义(P>0.05);术后2~8周,A组BBB评分显著高于B、C、D组,B、C组显著高于D组(P<0.05),B、C组间差异无统计学意义(P>0.05)。HE染色示,A组神经纤维排列整齐,无缺损及脱髓鞘改变;B组神经纤维结构欠清晰,轻度肿胀;C组神经纤维部分结构紊乱,局部脱髓鞘改变;D组神经纤维连续性欠佳,明显脱髓鞘改变,神经外膜部分缺损。透射电镜观察示,A组神经纤维结构清晰,髓鞘完整,细胞核致密;B组较A组稍次之;C组神经纤维结构模糊,有脱髓鞘改变;D组神经纤维结构紊乱,有脱髓鞘改变,神经外膜连续性中断。Western blot检测示,各组Nestin蛋白相对表达量比较差异均无统计学意义(P>0.05)。B、C、D组N-cadherin蛋白相对表达量显著低于A组,C、D组低于B组,D组低于C组,差异均有统计学意义(P<0.05)。B、C、D组GFAP蛋白相对表达量显著低于A组,D组显著低于B、C组,差异有统计学意义(P<0.05);B、C组间差异无统计学意义(P>0.05)。结论自体i-PRF与BMSCs联合使用可有�Objective To investigate the effectiveness of autologous injectable platelet rich fibrin(i-PRF)combined with bone marrow mesenchymal stem cells(BMSCs)for sciatic nerve injury in rats.Methods BMSCs were isolated and cultured from tibial bone marrow of Sprague Dawley(SD)neonatal rats aged 10-15 days and passaged to the 4th generation.i-PRF was prepared from posterior orbital venous blood of adult SD rats by improved low-speed centrifugation.Twenty-four adult SD rats were selected and randomly divided into 4 groups with 6 rats in each group after the sciatic nerveⅢdegree injury model was established by modified crush injury method.Groups A,B,C,and D were injected with BMSCs suspension+autologous i-PRF,autologous i-PRF,BMSCs suspension,and normal saline,respectively.The Basso-Beattie-Bresnahan(BBB)score was used to evaluate the recovery of neurological function of the affected limb of rats every week from 1 to 8 weeks after operation.At 2 months after operation,the rats were sacrificed and the histological changes of sciatic nerve were observed by HE staining.The microstructural changes of nerve fibers,myelin sheath,and nucleus were observed by transmission electron microscope.The expressions of N-cadherin,Nestin,and glial fibrillary acidic protein(GFAP)were detected by Western blot.Results No immune rejection or death occurred in the rats after operation.There was no significant difference in BBB scores between groups at 1 week after operation(P>0.05);at 2-8 weeks after operation,BBB scores in group A were significantly higher than those in groups B,C,and D,and in groups B,C than in group D(P<0.05),there was no significant difference between groups B and C(P>0.05).HE staining showed that the nerve fibers in group A arranged in order,without defect or demyelination;the nerve fibers in group B were not clear and slightly swollen;some of the nerve fibers in group C were disordered and demyelinated;the nerve fibers in group D were not continuous,obviously demyelinated,and some of the nerve adventitia damaged.Transmiss

关 键 词：神经组织工程 注射型富血小板纤维蛋白 BMSCS 神经损伤 大鼠 

分 类 号：R745[医药卫生—神经病学与精神病学]