坐骨神经损伤对大鼠牵张成骨区骨再生影响的实验研究  

Sciatic nerve injury and its effect on bone regeneration in distraction osteogenesis zone in rat

作　　者：刘凯 任鹏[1] 刘彦士 蔡飞宇 范琛琛 阿不来提·阿不拉[1] 艾合买提江·玉素甫[1] LIU Kai;REN Peng;LIU Yanshi;CAI Feiyu;FAN Chenchen;ABULAITI·Abula;AIHEMAITIJIANG·Yusufu(Department of Trauma and Microreconstructive Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院骨科中心显微修复外科,乌鲁木齐830054

出　　处：《中华显微外科杂志》2022年第2期181-188,共8页Chinese Journal of Microsurgery

基　　金：国家自然科学基金(81560357);新疆维吾尔自治区自然科学基金(2020D01C250)。

摘　　要：目的探讨坐骨神经离断修复对大鼠牵张成骨区骨再生的作用及机制。方法2021年1月至2021年8月,选取健康成年雄性SD大鼠60只运用随机抽样法分为A、B、C组。B、C组先分别于右侧坐骨神经行离断修复术,待神经愈合到8、12周后,3组分别行右侧股骨截骨延长外固定术(Ilizarov术)建立牵张成骨模型。股骨截骨延长术(Ilizarov术)前及术后行肌电诱导仪(EMG)检测周围神经电生理改变,术后每周行X线检查骨痂生成情况。矿化2、4、6周分别取材行四点弯曲实验和组织学染色检测牵张成骨区的骨再生情况。应用SPSS 21.0软件统计分析,计量资料以均数±标准差(Mean±SD)表示,运用非参数检验评估,当P<0.05时为差异有统计学意义。图表通过GraphPad Prism 8.0绘制。结果A组在术前及术后坐骨神经功能指数(SFI)、复合肌肉动作电位(CMAP)及运动神经传导速度(MNCV)优于B、C组;矿化第2、4周,X线片示B组成骨优于A、C组;HE及Safranin O染色示B组局部毛细血管及软骨形成明显多于A、C组;免疫组化染色示B组牵张区骨桥蛋白(Opn)和骨钙素(Ocn)表达量高于A、C组;矿化第6周,四点弯曲实验示B组骨质量优于A、C组。以上差异均有统计学意义(P<0.05)。结论合并坐骨神经损伤骨延长组的牵张区骨再生较单纯骨延长组愈合良好,股骨延长过程造成坐骨神经损伤后其电生理改变呈周期性变化,该损伤在术后6周可逐渐恢复。Objective To evaluate the effect and mechanism of bone regeneration in distraction osteogenesis zone after the repair of sciatic nerve in rats.Methods Between January 2021 and August 2021,60 healthy adult male Sprague-Dawley rats were divided randomly into 3 groups:Group A,B,and C.In groups B and C,right sciatic nerve transection and anastomosis were performed.Then after 8 and 12 weeks,the 3 groups were treated with extension external fixation(Ilizarov technique)of right femur osteotomy to make distraction osteogenesis model.Electrophysiological changes of peripheral nerves were monitored by electromyography(EMG)pre-and postoperatively in all the femoral lengthening rats.The formation of callus was examined by X-ray every week after operation.The rats were sacrificed on 2nd,4th,6th weeks after the bone transport operation.Four-point bending test and histological staining examination were carried out to determine the osteogenesis in the distracted area.SPSS 21.0 was used for statistical analysis.Data of measurement were expressed as(Mean±SD).A non-parametric test was used to assess the statistical difference between groups.Graphs were plotted by GraphPad Prism 8.0 and considered statistically significant when P<0.05.Results The results of Sciatic nerve function index(SFI),Compound muscle action potential(CMAP)and Motor nerve conduction velocity(MNCV)in group A were better than the group B and group C in both of before and after the surgery.At the 2nd and 4th weeks of the consolidation stage,X-ray showed that bone formation in group B was superior to groups A and C;HE and Safranin O staining showed that local capillary and cartilage formation in group B was significantly more than in groups A and C;Immunohistochemical staining showed that the expression levels of Osteopontin(Opn)and Osteocalcin(Ocn)in the distraction area of group B were higher than that of groups A and C.At the 6th week of the consolidation stage,the four-point bending test showed that the bone quality of group B was better than groups A and C.Th

关 键 词：神经修复 ILIZAROV技术 肢体延长 动物模型 大鼠 

分 类 号：R651.1[医药卫生—外科学]