CAJ | 학술논문

目的探讨碱性成纤维细胞因子(bFGF)与维生素C复合降解膜防止肌腱粘连的可行性。方法 60只新西兰大耳白兔随机平均分成实验组和对照组。常规手术制备自体肌腱移植动物模型,实验组肌腱移植处包裹bFGF与维生素C复合降解膜,对照组不包裹。术后第3周常规HE染色和硝酸银染色分别观察2组成纤维细胞核和维生素C的变化,Luzex-F图像分析仪测定胶原纤维数量,术后第8周测定移植腱腱周粘连程度和最大抗拉力值。结果术后第3周,实验组成纤维细胞核和维生素C银染颗粒明显多于对照组;实验组肌腱内部胶原纤维数量(1230.5±56.4)根,明显多于对照组(998.4±26.2)根,差异有统计学意义(t=11.78,P＜0.001)。术后第8周,实验组腱周粘连程度(Ⅰ级为1根,Ⅱ级7根,Ⅲ级2根,Ⅳ级0根,Ⅴ级0根)明显轻于对照组(Ⅰ级0根,Ⅱ级0根,Ⅲ级1根,Ⅳ级1根,Ⅴ级8根),差异有统计学意义(Z =3.922,P＜0.005),实验组移植腱最大抗拉力值(17.38±1.73)N明显高于对照组(11.65±1.29)N,差异有统计学意义(t=8.39,P＜0.001)。结论 bFGF与维生素C复合降解膜可以促进成纤维细胞增殖和胶原纤维合成,提高肌腱生物力学性能,防止肌腱粘连。
목적 탐토감성성섬유세포인자(bFGF)여유생소C복합강해막방지기건점련적가행성。방법 60지신서란대이백토수궤평균분성실험조화대조조。상규수술제비자체기건이식동물모형,실험조기건이식처포과bFGF여유생소C복합강해막,대조조불포과。술후제3주상규HE염색화초산은염색분별관찰2조성섬유세포핵화유생소C적변화,Luzex-F도상분석의측정효원섬유수량,술후제8주측정이식건건주점련정도화최대항랍력치。결과 술후제3주,실험조성섬유세포핵화유생소C은염과립명현다우대조조;실험조기건내부효원섬유수량(1230.5±56.4)근,명현다우대조조(998.4±26.2)근,차이유통계학의의(t=11.78,P＜0.001)。술후제8주,실험조건주점련정도(Ⅰ급위1근,Ⅱ급7근,Ⅲ급2근,Ⅳ급0근,Ⅴ급0근)명현경우대조조(Ⅰ급0근,Ⅱ급0근,Ⅲ급1근,Ⅳ급1근,Ⅴ급8근),차이유통계학의의(Z =3.922,P＜0.005),실험조이식건최대항랍력치(17.38±1.73)N명현고우대조조(11.65±1.29)N,차이유통계학의의(t=8.39,P＜0.001)。결론 bFGF여유생소C복합강해막가이촉진성섬유세포증식화효원섬유합성,제고기건생물역학성능,방지기건점련。
Objective To investigate the feasibility of preventing tendon adhesion by using bFGF/ vitamin C composite biodegradable membrane.MethodsSixty Newzerland rabbits were divided into experimental and control groups randomly.After the animal model was established, the tendon autografts were encapsulated with the bFGF/vitamin C composite biodegradable membrane in experimental group, while no tendon autografts encapsulation in control.Three weeks after surgery, regular HE staining and AgNO3 staining were performed to observe the fibroblast nuclei and vitamin C.The quantity of collagen fibrils was measured by Luzex-F Image Analyzer.Eight weeks after surgery, the peritendinous adhesion and the maximum tensile load were analyzed.Results At 3 weeks after surgery, the numbers of vitamin C granules, fibroblast nuclei and collagen fibrils in the experimental group were significantly more than those in the control group(t = 11.78 ,P ＜0.001) .At 8 weeks after surgery, the peritendinous adhesion in the experimental group was significantly slighter than that in the control group(Z =3.922,P ＜0.005) ,and the maximum tensile load in the experimental group was significantly higher than that in the control group (t = 8.39, P ＜ 0.001) .Conclusion bFGF/vitamin C composite biodegradable membrane can stimulate the proliferation of fibroblasts and synthesis of collagen fibrils,improve the biomechanical property of tendon autografts and prevent the tendon adhesion.