局部脉冲振动刺激对兔前交叉韧带重建后本体感觉恢复的影响  

Effect of local impulse vibration stimulation on proprioception recovery after anterior cruciate ligament reconstruction in rabbits

作　　者：张新强 王博 冯会成[1] ZHANG Xinqiang;WANG Bo;FENG Huicheng(Department of Orthopedics,Eighth Medical Center,PLA General Hospital,Beijing 100091,China;Department of Surgery,Graduate School,Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]解放军总医院第八医学中心骨科,北京100091 [2]河北北方学院研究生学院外科,河北张家口075051

出　　处：《吉林大学学报（医学版）》2023年第6期1407-1414,共8页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金面上项目(61871382)。

摘　　要：目的:探讨不同局部脉冲振动刺激治疗条件对兔前交叉韧带重建(ACLR)术后本体感觉恢复的影响,为临床实践提供参考。方法:选取45只健康新西兰大白兔,15只兔制备同种异体移植肌腱,30只兔制备前交叉韧带(ACL)模型,造模后将兔随机分为对照组和9个振动刺激治疗组(振动刺激治疗1~9组),每组3只。正交实验设计振动刺激治疗参数,采集各组兔ACL样本。HE染色观察各组兔ACL本体感受器形态表现,S100免疫组织化学染色观察各组兔ACL本体感受器分型,计数各组兔ACL本体感受器细胞数,实时荧光定量PCR (RT-qPCR)法检测各组兔ACL组织中生长相关蛋白43 (GAP-43)mRNA表达水平,正交分析法筛选ACLR术后康复振动刺激治疗的最优参数。结果:兔移植物张力尚可,无松弛状态,前抽屉实验和Lachman实验阴性;ACL组织移植物连续性存在,与胫骨和股骨腱骨愈合。ACL本体感受器中Ruffini小体为卵圆形或树突状形态,直径25~330μm;Pacinian小体为圆形或椭圆形感受器,直径40~220μm;Golgi腱器官感受器呈梭形,直径140~900μm;游离神经末梢为无髓鞘神经末梢,长度0.5~1.5μm。移植ACL中本体感受器主要分布于ACL的胫骨和股骨附着点,主要为类Ruffini小体和类Pacinian小体,无典型的类Golgi腱器官。与对照组比较,振动刺激治疗3、振动刺激治疗5和振动刺激治疗7组兔ACL本体感受器细胞数明显增加(F=28.49,P<0.01)。各组兔ACL组织中GAP-43 mRNA表达水平比较差异无统计学意义(F=0.83,P>0.05)。振幅强度、振动频率和作用时间对局部脉冲振动刺激治疗ACLR术后本体感受器数均存在较大影响,影响程度为振幅强度>作用时间>振动频率。其中最优振幅强度为3 mm,最优振动频率为25 Hz,最佳作用时间为10 min。结论:局部脉冲振动刺激治疗可促进兔ACLR术后ACL本体感受器恢复,采用低振幅、低振动频率和短时间的局部脉冲振动刺激治疗可加快ACLR术后本体�Objective:To discuss the effect of different local pulse vibration stimulation treatment conditions on the recovery of proprioception after anterior cruciate ligament reconstruction(ACLR)in the rabbits,and to provide the reference for clinical practice.Methods:A total of 45 healthy New Zealand white rabbits were selected,15 rabbits were used to prepare the allogenic tendon grafts,and 30 rabbits were used to prepare the anterior cruciate ligament(ACL)model.After modeling,the rabbits were randomly divided into control group and nine vibration stimulation treatment groups(vibraory stimulation treatment groups 1—9),and there were three rabbits in each group.Orthogonal experiment was used to design the vibration stimulation treatment parameters,and the ACL samples of the rabbit in various groups were acquired;HE staining was used to observe the morphology of the proprioceptors of the rabbits in various groups;S100 immunohistochemistry staining was used to observe the types of proprioceptors of the rabbits in various groups;the number of proprioceptive cells of the rabbits in various groups was counted;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression level of growth associated protein-43(GAP-43)mRNA in ACL tissue of the rabbits in various groups;orthogonal analysis method was used to select the optimal parameters for the recovery vibration stimulation treatment after ACLR.Results:The graft tension was satisfactory,without slack state,with negative front drawer and Lachman tests;the continuity of graft could be seen in ACL tissue of the rabbits,healing with the tibial and femoral tendons.The Ruffini corpuscles in the ACL proprioceptor were oval or dendritic,with the diameters of 25—330μm;the pacinian corpuscles showed round or elliptical sensors,with the diameters of 40—220μm;the Golgi tendon organs showed fusiform,with the diameters of 140—900μm;the free nerve endings were myelin-free nerve endings,with the diameters of 0.5—1.5μm.The proprioceptors in the transplant

关 键 词：前交叉韧带 振动刺激 本体感受器 康复 正交实验 

分 类 号：R684[医药卫生—骨科学] R493[医药卫生—外科学]