中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (34): 6313-6318.doi: 10.3969/j.issn.1673-8225.2010.34.011

• 组织工程神经材料 tissue-engineered nerve materials • 上一篇    下一篇

聚乳酸聚羟基乙酸共聚物三维神经导管修复周围神经缺损

李志跃1，李际才2，赵  群1   

  1. 1中南大学湘雅三医院骨科，湖南省长沙市  410013；2湖南省石门县人民医院骨科，湖南省常德市  415137
  • 出版日期:2010-08-20 发布日期:2010-08-20
  • 通讯作者: 李际才，副主任医师，湖南省石门县人民医院骨科，湖南省常德市 415137
  • 作者简介:李志跃☆，男，1969年生，湖南省邵阳市人，汉族，2001年中山大学毕业，博士，副教授，主要从事脊柱、周围神经的研究。 lizhiyuecs@163.com
  • 基金资助:

    湖南省自然科学资金资助项目(06jj4022)。

Polylactic/poly glycolic acid copolymer three-dimensional conduit repairs peripheral nerve defects

Li Zhi-yue1, Li Ji-cai2, Zhao Qun1   

  1. 1 Department of Orthopedic Surgery, The Third Xiangya Hospital of Central South University, Changsha   410013, Hunan Province, China; 2 Department of Orthopaedics, Shimen People's Hospital, Changde   415137, Hunan Province, China
  • Online:2010-08-20 Published:2010-08-20
  • Contact: Li Ji-cai, Associate chief physician, Department of Orthopaedics, Shimen People's Hospital, Changde 415137, Hunan Province, China
  • About author:Li Zhi-yue☆, Doctor, Associate professor, Department of Orthopedic Surgery, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China lizhiyuecs@163.com
  • Supported by:

     the Natural Science Foundation of Hunan Province No.06jj4022*

PDF

387

被引次数

32

摘要：

背景：异体神经移植由于存在难以消除的宿主免疫排斥反应，限制了其使用，许多学者试图用其他组织替代来弥补以上不足，但效果均不满意。目前，尚没有研制出公认的效果满意的人工神经，自体神经移植至今仍被认为是最佳选择。
目的：观察聚乳酸聚羟基乙酸共聚物(PLGA，85∶15)三维神经导管修复大鼠周围神经缺损的可行性，及神经导管内微丝支架的作用和不同数量微丝对神经再生的影响。
方法：40只成年SD大鼠随机数字表法分为4组，制作大鼠12 mm的左侧坐骨神经缺损模型，用该导管桥接大鼠12 mm的坐骨神经缺损。A组：PLGA神经导管组；B组：PLGA神经导管内纵形放入20根PLGA微丝；C组：PLGA神经导管内纵形放入40根PLGA微丝；D组：自体神经移植组。A、B、C组神经导管内均注入层粘蛋白+神经生长因子混合液。造模后动态观察大鼠肌肉萎缩、跛行情况，测量神经导管内再生神经的传导速度、小腿三头肌湿质量恢复率。对再生神经中1/3段行组织学观察及图像分析以评价神经修复的效果。
结果与结论：造模后各组再生神经均已通过神经导管长入远端，B、D组再生神经较A、C组粗大；再生神经的运动神经传导速度B组和D组明显快于A组和C组(P < 0.05)；A组、C组肌肉萎缩最明显，而B组、D组肌肉萎缩较轻且肌肉萎缩程度基本相当。病理图像分析神经纤维计数以D组最多，B组次之，而与A组、C组相比差异均有显著性意义(P < 0.05)，B组与D组的再生神经纤维数量及成熟程度均要明显优于A组和C组。提示新型的PLGA三维神经导管能有效引导SD大鼠坐骨神经长过12 mm的神经缺损，是一种较理想的神经导管；神经导管内微丝支架能有效引导神经再生，数量过多反而可能抑制神经再生。

关键词: 聚乳酸聚羟基乙酸共聚物, 周围神经损伤, 三维神经导管, 组织工程, 大鼠

Abstract:

BACKGROUND: Allogeneic nerve graft is restricted due to difficulty to eliminate host immune rejection, many scholars have tried to substitute with other tissues, but the results are unsatisfactory. At present, there is no an acknowledged artificial nerve with satisfactory results, nerve autograft is still considered the best choice.
OBJECTIVE: To study the feasibility of applying three-dimensional polylactic/poly glycolic acid (PLGA) conduit on repairing rat peripheral nerve defects, and to investigate the role of microfilaments in conduit and influence of various amounts of microfilaments on neural regeneration.
METHODS: A 12-mm defect in left sciatic nerve was produced in 40 adult SD rats, which were randomly divided into 4 groups: Group A: PLGA conduit; Group B: PLGA conduit plus 20 microfilaments; Group C: PLGA conduit plus 40 microfilaments; Group D: nerve autograft. PLGA conduit was filled with laminin and nerve growth factor mixture. After operation, muscular atrophy and limp were dynamically observed, conduction velocity of regenerated nerves in conduit and resumption rate of wet weight of triceps muscle were measured. Histological and imaging analysis were performed in 1/3 segment of the regenerated nerves for the recovery of nerve repair. 
RESULTS AND CONCLUSION: All the regenerated nerved grew into the distal end via conduits after modeling. The diameter of regenerating nerves was thicker in group B and D than in group A and C. Compared group B and D with group A and C, the conducting velocity was faster (P < 0.05). The atrophy of triceps muscle regained better in group B and D than in group A and C, however, there was no significant difference between group B and D as to atrophy of triceps muscle. Pathological imaging analysis showed that, the amount of nerve fibers was the most in group D, then in group B. There were significant differences between group A and group C (P < 0.05). The amount and density of nerve fibers in group B and D were superior to that in group A and C. The new three-dimensional conduit made with PLGA and microfilaments can effectively repair nerve defect in sciatic nerve of SD rats, thus considered as an ideal nerve conduit; Microfilaments in nerve conduit can guide neural regeneration, excessive microfilaments may inhibit neural regeneration.

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