异种化学去细胞神经移植修复大鼠坐骨神经缺损功能评价.docVIP

异种化学去细胞神经移植修复大鼠坐骨神经缺损功能评价 　 作者：赵志钢，陈秉耀，魏海温，王成琪，吴宝岭 【摘要】 ［目的］评价异种化学去细胞神经移植修复大鼠坐骨神经缺损后神经功能恢复，从而为临床应用去细胞异种神经移植修复神经缺损提供更为充分的理论依据。［方法］雄性Wistar大鼠15只，致左侧坐骨神经1 cm缺损，以等粗兔化学去细胞神经移植修复。每2周测定坐骨神经指数，移植后4个月动物麻醉后暴露移植段神经，刺激近侧神经干、于同侧胫后肌群记录运动诱发电位，之后取移植段神经切片后行HE组织化学及NF-160免疫组织化学染色。 ［结果］去细胞异种神经移植物未被宿主排斥，大量神经纤维长入移植物，神经电生理及坐骨神经指数显示宿主坐骨神经功能有部分恢复。［结论］去细胞异种神经移植可以作为修复周围神经缺损的一种有效方法。 【关键词】 外周神经缺损； 去细胞异种神经移植； 功能恢复 Abstract：［Objective］To observe the nerve regeneration and functional recovery in the adult rats.［Method］The sciatic nerves on the left side of 15 rats were exposed and 1.0 cm long segments of the nerves were removed from the midthigh level and replaced by rabbit nerve made acellular through chemical extraction.At 4 months after procedure,the nerve regeneration and function recovery were examined with HE staining,NF160 immunohistochemical staining,electrophysiological tests and sciatic functional index (SFI).［Result］In the rats repaired by acellular nerves,regenerated axons reentered into the acellular xenonerve segments without excessive sign of inflammation following implantation.As stimuling(1.5 mA,0.1 ms,1.0 Hz) to the proximal sciatic nerves,the implanted segment resulted in motor evoked potentials,which were recorded from posterior tibial muscles.SFI showed a partial recovery of locomotion of the limb with sciatic nerve defect.［Conclusion］Sciatic nerves defect can be repaired by chemical acellular xenogeneous nerves in rats.There was partial functional recovery,which revealed the grafting with chemical acellular xenogeneous nerves may be a promising mehod for nerve defect in clinical. Key words：peripheral nerve defect; acellular xenogeneous nerve transplantation; functional recovery 周围神经的缺损在战创伤中十分常见，其修复一直是医学界的一个棘手问题。在临床上， 自体神经移植是最基本和最可靠的方法。但自体神经移植来源有限，移植神经多为腓肠神经等的细小皮神经，无法满足较大神经缺损和广泛神经缺损修复的需要， 同时，自体神经移植不可避免的会造成二次创伤、供区功能障碍、感觉缺失、瘢痕形成和神经瘤性疼痛等，故在临床应用上受到限制。近年来，有学者发现，对同种异体神经进行特定的化学萃取处理，可清除神经中的细胞及髓鞘成分从而基本消除抗原性，同时由于保留了神经的基管膜及板层结构而成为神经纤维再生的良好支架，他们相继以化学去细胞同种异体神经移植修复大鼠、兔及犬的坐骨神经缺损获得成功［