摘要
目的建立兔硬脑膜缺损模型,应用不同材料进行修补,检测修补后脑脊液炎性指标的变化,探讨引起炎性改变的主要原因,证明纳米细菌纤维素膜是一种优良的硬脑膜替代材料。方法普通级成年健康雄性新西兰兔50只,体质量约2.5 kg。随机分为5组(Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ),每组各10只,Ⅰ组不做任何处理,为空白对照组,余各组手术去除兔双侧额顶部骨瓣及Ⅲ、Ⅳ、Ⅴ组硬脑膜。Ⅱ组为假手术组,保留自身完整硬脑膜,Ⅲ组为未修补组,Ⅳ组行市售人工硬脑膜修补,Ⅴ组予以纳米细菌纤维素膜修补。分别于手术后第3天、第7天、第14天、第30天、第90天应用经皮枕大池穿刺的方法采集脑脊液,进行脑脊液培养,排除阳性实验兔,余利用酶联免疫吸附分析(ELISA)测定实验检测相关炎性指标白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α的变化。结果所有兔均成功提取脑脊液。Ⅲ组在术后第7天出现1只新西兰兔的脑脊液培养结果为阳性,其余各时间点各组培养结果均为阴性;将阳性兔予以排除。与Ⅰ组相比,3种炎性因子的含量在Ⅱ组中变化不大,在Ⅲ组和Ⅳ组中明显增高,在Ⅴ组中,除术后第90天的IL-6外,余各时间点均增高。与Ⅲ组相比,Ⅳ组在术后第3天和第7天的IL-1β、IL-6和TNF-α,术后第14天的IL-1β、术后第90天的IL-6含量,明显较低。Ⅴ组在术后第3天和第7天的IL-1β、IL-6和TNF-α,术后第14天和第30天的IL-1β,术后第90天的IL-6含量均较Ⅲ组低;Ⅳ组与Ⅴ组相比,IL-1β在术后第3天,IL-6在术后第3天、第7天、第90天和TNF-α在术后第3天、第7天、第14天的含量,Ⅴ组明显较低。结论纳米细菌纤维素膜用于修补兔硬脑膜缺损,可恢复硬脑膜的完整性,未见中枢神经系统感染,炎性因子表达量低,活体植入效果优良,是一种较为理想的生物硬脑膜替代材料。
Objective To establish the rabbit model of dural defects and repair with different materials, and detect changes of cerebrospinal fluid related indicators with major reasons and demonstrated that bacterial cellulose membrane could be used as good dural substitute material. Methods Fifty ordinary healthy adult male New Zealand rabbits with body weight about 2.5 kg were randomly divided into 5 groups（group Ⅰ , group Ⅱ, group Ⅲ, group Ⅳ, group Ⅴ, n = 10）, group Ⅰ was blank control group without any operation, the other groups were removal bilateral frontal bone flap and dura mater of group Ⅲ, Ⅳ and Ⅴ. Group Ⅱ was the sham-operation group with reserving dura mater, group Ⅲ was no repaired, group Ⅳ was repaired by commercially available artificial dura. And group V was repaired by bacterial cellulose membrane. The puncture by cisterna magna was executed at the 3rd, 7th, 14th, 30th, 90th days after operation to extract the cerebrospinal fluid and excluded the positive results of bacterial culture, and then used the enzyme-linked immunosorbent assay（ELISA） to detect changes of inflammation-related indicators of interleukin（IL）-1β, IL-6, tumor necrosis factor（TNF）-α. Results All of them were successfully extracted the cerebrospinal fluid. Group Ⅱ occurred the positive result of bacterial culture in 1 rabbit（day 7）, others revealed negative results. Compared with group Ⅰ , three inflammation-related indicators were no changes in group Ⅱ, and obviously elevated in group Ⅲ, Ⅳ and V, but excluded IL-6 at day 90 in group Ⅴ. Compared with group Ⅲ, IL-1β, IL-6 and TNF-α（day 3 and day 7）, IL-1β（day 14）, IL-6（day 90） in group Ⅳ were lower. The IL-1β, IL-6 and TNF-α（day 3 and day 7）, IL-1β（day 14 and day 30）, IL-6 （day 90） in group V were lower. Compared with group Ⅳ, IL-1β （day 3）, IL-6（day 3, day 7 and day 90） and TNF-α（day 3, day 7 and day 14） in Ⅴ group were lower. Conclusion It is demonstrated that nacterial cellulose membrane used in repairing rabbit dural defect, which could restore the integrity of dura mater without central nervous system infection and reveal lower levels of inflammatory cytokines. It is an ideal biological dural substitute material with good effects in vivo.
作者
荆尧
王凯
徐晨
马霞
陈世文
JING Yao WANG Kai XU Chen MA Xia CHEN Shi-wen(Department of Neurosurgery, the Sixth People＇s Hospital, Shanghai Jiaotong University, Shanghai 200233, China School of Perfume and Aroma Technology, Shanghai Institute of Technalogy, Shanghai 201418, China)
出处
《生物医学工程与临床》
CAS
2017年第3期223-228,共6页
Biomedical Engineering and Clinical Medicine
基金
上海交通大学"医工(理)交叉研究基金"项目(YG2012MS34)
关键词
纳米细菌纤维素膜
硬脑膜替代材料
脑脊液
炎性因子
nano bacterial cellulose membrane
dural substitute material
cerebrospinal fluid
inflammatory cytokines
