CAJ | 학술논문

背景:碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)能促进体外腱细胞的增殖及胶原分泌,并促进鞘外肌腱的愈合,但其对鞘内肌腱的作用的资料较少.目的:探讨外源性bFGF对鞘内肌腱愈合和粘连形成的作用.设计、时间及地点:随机对照动物实验,于2004-05/2005-02在上海市第六人民医院实验动物中心实验室完成.材料:成年雄性来亨鸡90只制备鸡右爪第3趾趾深屈肌腱横断模型,随机均分为3组,每组30只.方法:对照组:肌腱横行切断后原位修复.纤维蛋白封闭剂组:在肌腱断端使用纤维蛋白封闭剂0.6 μ L后,原位修复肌腱.bFGF组:在断端使用bFGF和内含bFGF 500 ng的纤维蛋白封闭剂混合物0.6 μ L,原位修复肌腱.主要观察指标:术后1,2,4,8周,每组各取6只鸡进行大体、组织学检测:术后8周每组再取6只鸡进行生物力学测定.结果:对照组与纤维蛋白封闭剂组间各项观测指标比较均无显著性差别,与对照组和纤维蛋白封闭剂组相比,bFGF组修复部位腱鞘、腱外膜及腱实质的新生血管形成、成纤维细胞增殖较好,胶原的分泌出现早,数量也较多;肌腱滑动距离较短,屈曲功和肌腱最大抗拉力较大.结论:在肌腱断端使用外源性bFGF能促进鞘内肌腱的愈合,但也加重了肌腱的粘连.
배경:감성성섬유세포생장인자(basic fibroblast growth factor,bFGF)능촉진체외건세포적증식급효원분비,병촉진초외기건적유합,단기대초내기건적작용적자료교소.목적:탐토외원성bFGF대초내기건유합화점련형성적작용.설계、시간급지점:수궤대조동물실험,우2004-05/2005-02재상해시제륙인민의원실험동물중심실험실완성.재료:성년웅성래형계90지제비계우조제3지지심굴기건횡단모형,수궤균분위3조,매조30지.방법:대조조:기건횡행절단후원위수복.섬유단백봉폐제조:재기건단단사용섬유단백봉폐제0.6 μ L후,원위수복기건.bFGF조:재단단사용bFGF화내함bFGF 500 ng적섬유단백봉폐제혼합물0.6 μ L,원위수복기건.주요관찰지표:술후1,2,4,8주,매조각취6지계진행대체、조직학검측:술후8주매조재취6지계진행생물역학측정.결과:대조조여섬유단백봉폐제조간각항관측지표비교균무현저성차별,여대조조화섬유단백봉폐제조상비,bFGF조수복부위건초、건외막급건실질적신생혈관형성、성섬유세포증식교호,효원적분비출현조,수량야교다;기건활동거리교단,굴곡공화기건최대항랍력교대.결론:재기건단단사용외원성bFGF능촉진초내기건적유합,단야가중료기건적점련.
BACKGROUND: Basic flbroblast growth factor (bFGF) can promote tendon proliferation, collagen secretion,and out-sheathed tendon healing; however, effects on in-sheathed tendon are still unknown.OBJECTIVE: To explore the effects of exogenous bFGF on in-sheathed tendon healing and adhesion formation. DESIGN,TIME AND SETTING: A randomized controlled animal study, which was carried out in Experimental Animal Center, Shanghai Sixth People's Hospital from May 2004 to February 2005.MATERIALS: Ninety Leghorn chickens were randomly divided into 3 groups with 30 animals for each, and the right third digitorum longns tendon of the chicken was transected. METHODS: In the control group, the tendon was sutured in situ after transection. In the fibrin group,the tendon was sutured after 0.6 μL fibrin sealant (FS) was applied at repair site. In the bFGF group,the tendon was sutured after 0.6 μL FS mixed with 500 ng bFGF was applied at repair site. MAIN OUTCOME MEASURES: At 1,2,4 and 8 weeks postoperatively, the tendons of 6 chickens in each group were harvested for morphological and histological evaluation.Another six specimens of each group was obtained for biomechanical test at 8 weeks.RESULTS: There were no significant differences between control group and fibrin group. In bFGF group compared with control and fibrin groups, appearance of the angiogenesis,fibroblast proliferation and collagen production in the sheath, epitenon and parenchyrna at repair site occurred earlier and were more in quantity,the gliding excursion of the tendon was shorter, and the work of flexion and the ultimate tensile strength of the tendon were greater. CONCLUSION: The exogenous bFGF at tendon repair site can facilitate in-sheathed tendon healing, but also increase the tendon adhesion.