富血小板血浆促进面神经损伤后修复的实验研究  

Experimental study of platelet-rich plasma promoting facial nerve repair after injury

作　　者：李立恒 远洋[2,3] 魏建初 韩月臣[3] LI Liheng;YUAN Yang;WEI Jianchu;HAN Yuechen(Department of Otolaryngology,Huzhou Central Hospital,Huzhou 313000,China;Department of Otorhinolaryngology,Affiliated Hospital of Weifang Medical University,Weifang 261031,China;Shandong Institute of Otorhinolaryngology,Jinan 250023,China)

机构地区：[1]湖州市中心医院(湖州师范学院附属浙北临床医学院)耳鼻喉科,湖州313000 [2]潍坊医学院附属医院耳鼻喉科,潍坊261031 [3]山东省耳鼻喉研究所,济南250023

出　　处：《中国眼耳鼻喉科杂志》2023年第2期151-156,共6页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：湖州师范学院校级科研项目(2020XJKJ21);湖州市科技局项目(2021GYB36);山东省自然科学基金(ZR2020MH178);浙江省教育厅科研项目(Y202043772)。

摘　　要：目的探讨富血小板血浆(platelet-rich plasma,PRP)对面神经损伤的保护作用及其机制。方法实验用大鼠共100只,其中10只用于制备PRP,10只为对照组(A组),另外80只构建大鼠面神经夹挫伤模型。建模后的大鼠随机分为2组,每组40只,B组为自然恢复组,局部术区注射1周生理盐水,C组为PRP治疗组,局部术区注射PRP 1周。通过行为学和神经电生理观察各组大鼠PRP干预后即刻、1周、2周、3周的面神经功能,并对面神经行电子显微镜组织形态学观察,面神经核团行苏木精-伊红(HE)染色观察胶质细胞,通过聚合酶链反应(PCR)检测面神经核团中血小板活化生长因子(PAF)、核因子-κB(NF-κB),肿瘤坏死因子-α(TNF-α)、脑源性神经营养因子(BDNF)、神经营养因子-4(NT-4)的变化。结果行为学评估:建模后第1天,B组和C组大鼠患侧表现为完全性面瘫,干预后3周时,C组的面瘫评分较B组显著升高,差异具有统计学意义(P<0.05)。神经电生理评估:与A组相比,建模后第1天,B组和C组的面神经复合肌肉动作电位(CMAPs)潜伏期显著延长,波幅降低;干预后3周时,C组的潜伏期显著缩短,波幅明显升高。电子显微镜下C组面神经可见较多Schwann细胞核和正在形成的再生髓鞘。面神经核团染色显示,正常面神经运动神经元胞体为典型的多极运动神经元,周围分布神经胶质细胞,损伤后PAF、NF-κB、TNF-α、BDNF、NT-4的mRNA水平均升高,差异均具有统计学意义(P值均<0.01),PRP可降低这些因子的mRNA水平,对大鼠面神经损伤后面神经核团内相关因子的表达有抑制作用。结论PRP对外伤性面神经损伤具有保护作用,可能机制包括抑制PAF的激活和炎症介质的产生以及上调神经营养因子。Objective To investigate the protective effect and mechanism of platelet-rich plasma(PRP)on facial nerve injury.Methods A total of 100 rats were used in the experiment,in which 10 rats were used for PRP preparation,10 rats were set as the control group(group A),and the other 80 rats were used to construct the crush model of facial nerve injury.After the surgery,the 80 rats were randomly divided into 2 groups with 40 rats in each.Group B was given continuous injection of normal saline for 1 week,which was the natural recovery group;group C was given continuous injection of PRP in the local operative area for 1 week,which was the PRP treatment group.The facial nerve function of the rats in each group was observed immediately,1 week,2 weeks and 3 weeks after PRP or saline intervention by behavioral and neuroelectrophysiological observation.The facial nerve was observed by electron microscopy and the glial cells were observed by hematoxylin-eosin(HE)staining.The platelet-activating growth factor(PAF),nuclear factor-κB(NF-κB)and tumor necrosis factor-α(TNF-α),brain-derived neurotrophic factor(BDNF),neurotrophic factor-4(NT-4)in the facial nerve nucleus were detected by polymerase chain reaction(PCR).Results Behavioral evaluation:on the first day after intervention,the injury sides of group B and group C presented complete facial paralysis.Three weeks after intervention,the facial paralysis score of group C was significantly higher than that of group B,and the difference was statistically significant(P<0.05).Neuroelectrophysiological assessment:compared with group A,the latency of facial nerve complex muscle action potentials(CMAPs)in groups B and groups C was significantly prolonged and the amplitude of CMAPs was decreased on day 1 after intervention.Three weeks after intervention,the incubation period of group C was significantly shortened and the amplitude of the wave was significantly increased.More Schwann nuclei and regenerated myelin sheath were observed in group C facial nerves under electron microscope.The

关 键 词：面神经损伤 富血小板血浆 神经再生 

分 类 号：R76[医药卫生—耳鼻咽喉科]