几丁糖-胶原-丹参素缓释复合膜对兔腰椎板切除术后腰椎及硬膜外瘢痕组织的治疗作用  

Therapeutic Effect of Chitosan-Collagen-Salvianolic Acid Slow-release Composite Membrane on Lumbar Spine and Epidural Scar Tissue After Lumbar Laminectomy in Rabbits.

作　　者：曾瑞明 况君[2] 万宣 梁超轶 吴凡 舒志敏 梁卫东[1] 万小明[1] 余兆仲[1] ZENG Ruiming;KUANG Jun;WAN Xuan(Department of Trauma Orthopedics,Affiliated Hospital of Jiangxi University of Chinese Medicine,Jiangxi 330006,China)

机构地区：[1]江西中医药大学附属医院创伤骨科,南昌330006 [2]江西中医药大学附属医院脊柱科,南昌330006 [3]江西中医药大学附属医院儿童骨科,南昌330006

出　　处：《医学研究杂志》2025年第2期58-63,共6页Journal of Medical Research

基　　金：国家自然科学基金资助项目(82260943);万小明全国名老中医药专家传承工作室建设项目{国中医药人教函〔2022〕75号};江西省自然科学基金资助项目(20192BAB205097);江西省研究生创新专项(YC2023-S786)。

摘　　要：目的探究几丁糖-胶原-丹参素缓释复合膜对兔腰椎板切除术后腰椎及硬膜外瘢痕组织的治疗作用。方法选取雄性新西兰大耳兔分为假手术组、模型组、模型+SH组、模型+CC组和模型+CCS组。采用几丁糖、胶原蛋白Ⅰ型和丹参素按照一定比例制备复合膜材料,对新西兰大耳兔构建腰椎板切除动物模型后置入材料,于术后4周和8周处死动物,取L 1、L 2及T 12腰椎和硬膜外瘢痕组织进行检测,苏木精-伊红染色和Masson染色检测腰椎骨组织病理改变,生化试剂盒检测瘢痕组织中羟脯氨酸(hydroxyproline,HYP)的含量。结果术后4周和8周,模型组硬膜与瘢痕粘连紧密,无法钝性分离,模型组较假手术组骨小梁数量减少、厚度降低,同时伴有骨小梁断裂,排列紊乱,胶原连续性被破坏,HYP含量增加;置入不同材料后,硬膜与瘢痕间粘连减轻,骨小梁排列得到改善,小梁数量增加,骨胶原染色面积显著增加,骨胶原结构恢复,HYP含量在4周时均显著低于模型组(P<0.05),8周时HYP含量较模型组无显著性差异,仅模型+CC组含量显著下降(P<0.05)。结论几丁糖-胶原-丹参素缓释复合膜具有促进兔腰椎板切除术后组织的愈合修复作用。Objective To explore the therapeutic effect of a chitosan-collagen-salvianolic acid slow-release composite membrane on lumbar spine and epidural scar tissue after lumbar laminectomy in rabbits.Methods Chitosan,typeⅠcollagen,and salvianolic acid were used to prepare the composite membrane material in a specific ratio.After constructing a lumbar laminectomy animal model in New Zealand white rabbits,the material was implanted.The animals were sacrificed at 4 and 8 weeks after surgery,L 1,L 2 and T 12 lumbar spine and epidural scar tissue were collected.Hematoxylin-eosin staining and Masson staining were used to detect pathological changes in lumbar spine bone tissue,and a biochemical kit was used to measure the hydroxyproline(HYP)content in scar tissue.Results At 4 and 8 weeks after surgery,the model group showed tight adhesion between the dura mater and scar tissue,with inability to separate bluntly.The model group had reduced trabecular number and thickness compared to the sham group,with trabecular fractures,disordered arrangement,disrupted collagen continuity,and increased HYP content.After implantation of different materials,the adhesion between the dura mater and scar tissue decreased,trabecular arrangement improved,trabecular number increased,bone collagen staining area significantly increased,collagen structure was restored,and HYP content at 4 weeks was significantly lower than the model group(P<0.05).At 8 weeks,HYP content showed no significant difference compared to the model group,with only the model+CC group showed a significant decrease(P<0.05).Conclusion The chitosan-collagen-salvianolic acid slow-release composite membrane promotes the healing and repair of tissues after lumbar laminectomy in rabbits.

关 键 词：腰椎板切除术 复合膜材料 透明质酸钠 羟脯氨酸 

分 类 号：R681[医药卫生—骨科学]