摘要
背景:通过神经导管桥接修复周围神经缺损可为神经再生提供适合的微环境,一方面为神经再生提供唯一的通道,防止周围结缔组织的侵入和瘢痕的形成;另一方面,能保存内源性和外源性的神经营养因子、生长因子等促进轴突生长的刺激物质。目的:观察几丁糖/聚乙烯醇导管内注入脑源性神经营养因子缓释微球桥接周围神经缺损的效果。方法:采用反复冻融技术制备几丁糖/聚乙烯醇神经导管;采用乳化-溶剂挥发法与聚合物合金法制备脑源性神经营养因子缓释微球。在60只成年雄性SD大鼠右后肢制作15 mm坐骨神经缺损模型,随机分4组处理:A组植入自体坐骨神经,B组植入几丁糖/聚乙烯醇神经导管后注射生理盐水,C组植入几丁糖/聚乙烯醇神经导管后注射脑源性神经营养因子溶液,D组植入几丁糖/聚乙烯醇神经导管后注射脑源性神经营养因子缓释微球,每组15只。术后4个月取材,进行大体解剖观察、组织学检查和神经电生理测定。动物实验获得河北医科大学第二医院科研伦理委员会批准。结果与结论:①大体解剖:A、D组肌肉萎缩较另外2组轻,4组移植物均与周边组织有粘连,自体移植段神经与周围组织粘连较重,D组再生神经已将远、近两端神经连接,再生神经填满导管;②电生理检测:D组潜伏期短于B、C组(P <0.01),诱发电位与传导速度大于B、C组(P <0.01),与A组比较差异均无显著性意义(P> 0.05);③组织学观察:B、C、D组导管内均有再生神经纤维,D组再生神经纤维直径、个数及髓鞘厚度大于B、C组(P <0.01),与A组比较差异均无显著性意义(P> 0.05);④结果表明,几丁糖/聚乙烯醇导管内注入脑源性神经营养因子微球对于外周神经再生有较长期的促进作用。
BACKGROUND: The repair of peripheral nerve defects by nerve conduit bridging can provide a suitable microenvironment for nerve regeneration. On one hand, it can provide a unique channel for nerve regeneration, prevent the invasion of peripheral connective tissue and the formation of scars. On the other hand, it can maintain endogenous and exogenous neurotrophic factors, growth factors and other stimulants to promote axon growth.OBJECTIVE: To observe the therapeutic effect of chitosan/polyvinyl alcohol catheter injected with brain-derived neurotrophic factor sustained-release microspheres to bridge peripheral nerve defects.METHODS: Chitosan/polyvinyl alcohol nerve conduit was prepared by repeated freeze-thaw technique. The brain-derived neurotrophic factor microspheres were obtained by polymer-alloys combined with oil-oil emulsion/solvent evaporation method. A 15 mm sciatic nerve defect model was made in the right hindlimb of 60 adult male Sprague-Dawley rats. They were selected and randomly divided into four groups(n=15 per group): group A implanted with autogenous sciatic nerve;group B implanted with chitosan/polyvinyl alcohol nerve catheter, injected with normal saline;group C implanted with chitosan/polyvinyl alcohol nerve catheter, injected with brain-derived neurotrophic factor solution;group D implanted with chitosan/polyvinyl alcohol nerve catheter, injected with brain-derived neurotrophic factor sustained-release microspheres. General observation, histological inspection, and electrophysiological determination were performed at 4 months after the surgery. This study was approved by the Research Ethics Committee of the Second Hospital of Hebei Medical University. RESULTS AND CONCLUSION:(1) Gross anatomy showed that muscle atrophy in group A and group D was lighter than that in the other two groups. The grafts in four groups were all adhered to the peripheral tissues, and the nerve in the autotransplantation segment was strongly adhered to the peripheral tissues. In group D, the regenerated nerve had connected the distal and proximal nerves, and the regenerated nerve filled the conduit.(2) Electrophysiological examination showed that the latency of group D was shorter than that of groups B and C(P < 0.01), and the evoked potential and conduction velocity of group D were higher than that of groups B and C(P < 0.01). There was no significant difference between group D and group A(P > 0.05).(3) Histological observation showed that there were regenerated nerve fibers in groups B, C, and D. The diameter, number and thickness of myelin sheath of group D were larger than those of group B and group C(P < 0.01). There was no significant difference between group D and group A(P > 0.05).(4) The results showed that the injection of brain-derived neurotrophic factor microspheres into chitosan/PVA catheter had a long-term promoting effect on peripheral nerve regeneration.
作者
史正亮
张华
范志勇
马维
袁鹤
杨冰
Shi Zhengliang;Zhang Hua;Fan Zhiyong;Ma Wei;Yuan He;Yang Bing(Department of Orthopedics,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第10期1555-1559,共5页
Chinese Journal of Tissue Engineering Research
关键词
材料
支架
神经
神经导管
周围神经
神经缺损
脑源性神经营养因子
缓释微球
神经再生
materials
scaffold
nerve
nerve conduit
peripheral nerve
nerve defect
brain-derived neurotrophic factor
sustained release microspheres
nerve regeneration
