CAJ | 학술논문

背景:酸性成纤维细胞生长因子具有调节细胞增殖、移行、分化和生存的作用,也可以下调已知轴突再生的抑制因子如蛋白聚糖等,帮助轴突克服这些抑制因子,对神经纤维再生有重要作用.目的:观察酸性成纤维细胞生长因子联合周围神经移植治疗大鼠高位脊髓损伤的可行性及效果.方法:健康成年雌性SD大鼠108只随机抽签法分为自体神经组、自体神经联合生长因子组、高位脊髓横断组.咬除大鼠T_(8-10)棘突、椎板,显露硬膜囊,水平切断高位脊髓并切除3 mm,显微镜下确认无神经纤维相连.自体神经组、自体神经联合生长因子组取双侧第8～10对肋间神经各2 cm,将肋间神经交叉移植入高位脊髓缺损处(近端白质与远端灰质、远端白质与近端灰质),分别以纤维蛋白凝胶、含有酸性成纤维细胞生长因子的纤维蛋白凝胶固定植入的肋间神经,缝合硬膜.高位脊髓横断组断端间旷置.术后90 d,行体感诱发电位及运动诱发电位检测观察神经电生理恢复情况.术后76 d,生物素葡聚糖胺顺行神经示踪观察运动传导束恢复情况.术后60 d,后肢BBB运动功能评分观察肢体运动恢复情况.结果与结论:高位脊髓横断组大鼠均未引出体感及运动诱发电位波形.自体神经组、自体神经联合生长因子组均可引出体感及运动诱发电位,自体神经联合生长因子组体感诱发电位及运动诱发电位的平均潜伏期和波幅、BBB评分均明显优自体神经组(P＜0.01).自体神经组和自体神经联合生长因子组在损伤区有较多生物素葡聚糖胺标记阳性神经纤维通过,明显多于高位脊髓横断组(P＜0.01),自体神经联合生长因子组多于自体神.经组(P＜0.01).示自体周围神经移植酸性成纤维细胞生长因子能更好地恢复高位脊髓损伤后大鼠肢体运动功能.
배경:산성성섬유세포생장인자구유조절세포증식、이행、분화화생존적작용,야가이하조이지축돌재생적억제인자여단백취당등,방조축돌극복저사억제인자,대신경섬유재생유중요작용.목적:관찰산성성섬유세포생장인자연합주위신경이식치료대서고위척수손상적가행성급효과.방법:건강성년자성SD대서108지수궤추첨법분위자체신경조、자체신경연합생장인자조、고위척수횡단조.교제대서T_(8-10)극돌、추판,현로경막낭,수평절단고위척수병절제3 mm,현미경하학인무신경섬유상련.자체신경조、자체신경연합생장인자조취쌍측제8～10대륵간신경각2 cm,장륵간신경교차이식입고위척수결손처(근단백질여원단회질、원단백질여근단회질),분별이섬유단백응효、함유산성성섬유세포생장인자적섬유단백응효고정식입적륵간신경,봉합경막.고위척수횡단조단단간광치.술후90 d,행체감유발전위급운동유발전위검측관찰신경전생리회복정황.술후76 d,생물소포취당알순행신경시종관찰운동전도속회복정황.술후60 d,후지BBB운동공능평분관찰지체운동회복정황.결과여결론:고위척수횡단조대서균미인출체감급운동유발전위파형.자체신경조、자체신경연합생장인자조균가인출체감급운동유발전위,자체신경연합생장인자조체감유발전위급운동유발전위적평균잠복기화파폭、BBB평분균명현우자체신경조(P＜0.01).자체신경조화자체신경연합생장인자조재손상구유교다생물소포취당알표기양성신경섬유통과,명현다우고위척수횡단조(P＜0.01),자체신경연합생장인자조다우자체신.경조(P＜0.01).시자체주위신경이식산성성섬유세포생장인자능경호지회복고위척수손상후대서지체운동공능.
BACKGROUND: Acidic fibrobiast growth factor can regulate cell proliferation, migration, differentiation and survival, also can down-regulate the known inhibitor of axon regeneration, such as proteoglycan, help axons overcome these inhibitory factors, and have significant role on the regeneration of nerve fibers.OBJECTIVE: To study the feasibility and effect of the acidic fibroblast growth factor combined with peripheral nerve transplantation in the treatment of high-level spinal cord injury in rats.METHODS: A total of adult 108 female SD rats were randomly divided into autologous nerve group, autologous nerve combined .with acidic fibroblast growth factor group, and high-level spinal cord injury group. The rat T_(8-10) spinous process and lamina were bite, revealing dural sac, high-level spinal cord was resected at a horizon level, cutting 3 mm, no nerve fibers were confirmed to be attached under the microscope. In the autogenous nerve group and autologous nerve combined with acidic fibroblast growth factor group, bilateral the 8~(th) to 10~(th) pairs of intercostal nerves were harvested 2 cm, then cross-transplanted into high-level spinal cord defect (proximal white matter and distal gray matter, distal white matter and proximal gray matter), fibrin gel and fibrin gel containing acidic fibroblast growth factor were used respectively to fix the implanted intercostal nerve, followed by dural suture.High-level spinal cord transection group was subjected to exclusion between stumps. At 90 days postoperation, somatosensory evoked potential and motor evoked potential were used to test nerve electrophysiological recovery. At 76 days postoperation,biotinylated dextran amine anterograde tracing was applied to observe the motor conduction bundle recovery. At 60 days postoperation, hindlimb motor function recovery was assessed by BBB score.RESULTS AND CONCLUSION: The somatosensory and motor evoked potential waveforms were not elicited in rats of high-level spinal cord transaction group, but did elicit in autogenous nerve group and autologous nerve combined acidic fibroblast growth factor group. The average latency and amplitude of somatosensory and motor evoked potentials, as well as BBB scores in autologous nerve combined acidic fibrobiast growth factor group were significantly superior to autologous nerve group (P ＜ 0.01).In the autogenous nerve group and autologous nerve combined acidic fibroblast growth factor group, many more biotinylated daxtran amine-positive nerve fibers passed in the damage zone, compared with high-level spinal cord transection group (P ＜0,01), the autologous nerve combined acidic fibrobiast growth factor group was more than autogenous nerve group (P ＜ 0.01). It is indicated that autologous peripheral nerve graft acidic flbroblast growth factor can better restore the limb motor functions of rats after high-level spinal cord injury.