摘要
背景:正常骨组织和骨痂中有神经生长因子及其受体的表达,同时局部给予外源性神经生长因子对骨折愈合有促进作用,周围神经损伤后的骨折,骨痂质量受明显影响。目的:验证周围神经损伤后局部应用神经生长因子对骨折早期愈合的影响。设计、时间及地点:随机分组设计,对照动物实验,于2007-05/11在解放军济南军区总医院动物实验中心完成。材料:选用健康雄性Wistar大白鼠48只,体质量(220±20)g;神经生长因子注射液,厦门北大之路生物工程有限公司生产,批号20070502。方法:Wistar大白鼠48只分成4组,每组24肢体。①盐水组:胫骨骨折+盐水注射。②神经损伤盐水组:神经损伤+胫骨骨折+盐水注射。③神经生长因子组:胫骨骨折+神经生长因子注射。④神经损伤神经生长因子组:神经损伤+胫骨骨折+神经生长因子注射。先行测量胫骨中点处周径,然后在胫骨上段前侧楔形开槽,再于腹股沟韧带水平切除股神经约10mm。对侧作胫骨开槽,暴露但不切除神经。股神经切除侧同时行坐骨神经切除约10mm,对侧作切口暴露。术后盐水组和神经损伤盐水组肌注生理盐水,每侧肢体0.1mL/d;神经生长因子组和神经损伤神经生长因子组肌注神经生长因子,每侧肢体0.1mL(0.2U)/d。主要观察指标:术后2周、4周测量小腿周径、X射线线摄片、标本湿质量、骨痂计量学观察。结果:①神经损伤侧小腿萎缩明显,神经生长因子促进肌肉恢复。②神经损伤侧标本湿质量及骨痂量较对侧多。③2周及4周时,神经损伤盐水组、神经损伤神经生长因子组骨痂均较对侧多,但类骨质多,缺乏正常骨小梁结构。神经生长因子组、神经损伤神经生长因子组骨痂相对少而质密,骨小梁排列规则。结论:伴有或不伴有神经损伤的骨折,局部注射神经生长因子都可抑制破骨细胞活动,使成骨能力增强,促进骨折愈合。
BACKGROUND： It is exhibit that nerve growth factor （NGF） and its receptor expresses in normal bone tissue and callus, the local administration of exogenous NGF can promote the healing of fractures. When fracture following peripheral nerve injury happened the quality of callus significantly affected.
OBJECTIVE： To verify the effect of NGF on tibia with peripheral nerve injury in early-stage fracture healing.
DESIGN, TIME AND SETTING： A randomized grouping design, animal controlled experiment was performed at the Experimental Animal Center, General Hospital of Jinan Military Area Command of Chinese PLA between May and November 2007.
MATERIALS： Forty-eight mate Wistar rats, weighting （220±20） g; NGF injection was produced by Xiamen Road of Beijing University Bio-Engineering Co., Ltd. （Batch number： 20070502）.
METHODS： Forty-eight male Wistar rats were randomly divided into 4 groups, with 24 limbs in each group. Rats in the sodium chloride group were injected sodium chloride after tibia fracture. Rats in the nerve injury with sodium chloride group were injected sodium chloride after tibia fracture combined with nerve injury. In the NGF group, rats were injected NGF after tibia fracture. Rats in the nerve injury with NGF group were nerve injury plus tibia fracture plus NGF. First, the mid-point department circumference of tibia was measured, and then a wedge-shaped groove on the upper tibia anterior was got, and then femoral nerve about 10 mm at the level of the inguinal ligament was cut. Tibia slotted for the opposite, exposed, but not to remove nerve. Turn to prone position, executed the sciatic nerve with a length of about 10 mm on the side of femoral nerve resection at the same time. Contralateral incision exposed. After the surgery, sodium chloride group and nerve injury with sodium chloride group were injected with physiological saline, 0.1 mL/limb per day. The rats in the NGF group and nerve injury with NGF group were injected 0.1 mL （0.2 U） NGF per day.
MAIN OUTCOME MEASURES： The circumference of crus, X-ray film, wet weight of specimen, and callus metrology observation was measured at weeks 2 and 4 after operation.
RESULTS： （1）The crus shrunk more obvious after never injury, however, NGF promoted the muscle restoration. （2）The wet weight of specimen and callus at the nerve injury side was more than contralateral side. （3）There were more callus at the never injury side of nerve injury with sodium chloride group and nerve injury with NGF group than contralateral side at the 2 and 4 weeks, but there were more osteoid, which lacking of normal bone trabecula structure. The callus quantity of NGF group and nerve injury with NGF group had small amount of high density callus with orderly arrayed bone trabecula.
CONCLUSION： During fracture, whether nerve injury or not, local injection of NGF can have a passive effect.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第11期2057-2061,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
