高三尖杉酯碱对大鼠椎板切除术后硬膜外粘连的影响  

The study of the effect and safety of homoharringtonine in the prevention of postlaminectomy epidural adhesion in rats

作　　者：孙斌磊 戴纪杭 孙钰[2] 颜连启[2] 王静成[2] SUN Binlei;DAI Jihang;SUN Yu(Department of Joint Orthopedics,the Second Xiangya Hospital of Central South University,Changsha,410000,China;不详)

机构地区：[1]中南大学湘雅二医院骨科关节,长沙市410000 [2]江苏省苏北人民医院骨科关节,扬州市225001

出　　处：《中国脊柱脊髓杂志》2020年第5期454-458,共5页Chinese Journal of Spine and Spinal Cord

基　　金：江苏省医学创新团队(编号CXTDB2017004)。

摘　　要：目的:探讨局部应用不同浓度高三尖杉酯碱(homoharringtonine,HHT)对L1椎板切除术后大鼠硬膜外瘢痕粘连的预防效果。方法:将36只成年雄性SD大鼠,2月龄,体重279.42±32.58g(260~320g),随机分成A组(HHT 0.2mg/ml组)、B组(HHT 0.1mg/ml组)、C组(生理盐水组)。制作L1椎板切除术模型,显露硬脊膜,C组生理盐水冲洗后直接逐层闭合切口,A、B组分别用浸泡有不同浓度HHT的棉垫放入骨缺损区5min,生理盐水冲洗后再逐层闭合切口。术后1个月时,行大体标本及组织病理学(HE染色)观察硬膜外瘢痕粘连情况,并使用Image Pro Plus软件进行成纤维细胞计数以及胶原光密度值分析。结果:A组无明显粘连,B组存在轻度粘连,C组形成紧密的硬膜外瘢痕粘连。A组硬膜外瘢痕中胶原光密度值(0.063±0.014)及成纤维细胞计数(8.43±2.52个)较C组(0.186±0.005和22.47±2.37个)明显降低,且优于B组(0.126±0.017和14.60±1.67个)(P<0.05)。结论:局部应用高三尖杉酯碱对预防硬膜外粘连有效,可减少椎板切除术后瘢痕形成。且局部应用0.2mg/ml的高三尖杉酯碱防粘连效果更佳。Objectives:To determine the effect of local application of the homoharringtonine(HHT)in preventing postlaminectomy epidural adhesion in rats.Methods:A total of 36 adult male SD rats,aged 2 months and weight 279.42±32.58 g(260-320 g),were selected and randomly divided into group A(HHT 0.2 mg/ml group),group B(HHT 0.1 mg/ml group),and group C(normal saline group).The L1 laminectomy model was made and the dural membrane was exposed.In group C,the wound was closed layer by layer after normal saline irrigation.In groups A and B,cotton pads with different concentrations of HHT were soaked into the bone defect area for 5 min,and then the wound was closed layer by layer after normal saline irrigation.At 1 month after surgery,gross specimens and histopathology(HE staining)were used to observe the condition of epidural scar adhesion,and the fibroblast count and collagen optical density were analyzed by Image Pro Plus.Results:There were no obvious adhesions in group A,mild adhesions in group B,and tight epidural scar adhesions in group C.The collagen optical density and fibroblast count in epidural scar in group A was 0.063±0.014 and 8.43±2.52 respectively,which were significantly lower than that in group C(0.186±0.005 and22.47±2.37),and were better than that in group B(0.126±0.017 and 14.60±1.67)(P<0.05).Conclusions:Topical application of homoharringtonine has a good effect in preventing postlaminectomy epidural adhesion.

关 键 词：椎板切除术 大鼠 高三尖杉酯碱 硬膜外粘连 安全性 

分 类 号：K681.5[历史地理—历史学] K973[历史地理—世界史]