摘要
背景:A型肉毒毒素通过阻断白细胞介素1的激活而发挥其预防关节纤维性粘连的作用。目的:验证兔膝关节术后腔内注射A型肉毒毒素预防关节纤维性粘连的效果。设计、时间及地点:随机对照动物实验,于2008-07/10在山东潍坊医学院及潍坊市人民医院完成。材料:A型肉毒毒素为兰州生物制品研究所产品。4月龄健康雄性新西兰大白兔20只,体质量2.8～3.2kg,随机分为实验组和对照组,每组10只。方法:所有实验动物行右后肢膝关节前交叉韧带横断术诱导关节纤维性粘连形成。术后1周实验组与对照组膝关节腔内分别穿刺注射A型肉毒毒素0.6mL(50U)、生理盐水0.6mL,注射1次/周,共3次。主要观察指标:术后6周对所有实验动物右后肢膝关节行生物力学测定、大体观察、粘连程度半定量评分以及组织学观察。结果:生物力学测定结果表明,实验组屈曲挛缩角度明显小于对照组(P<0.01),实验组粘连发生率及半定量评分明显低于对照组(P=0.005,P<0.01)。光镜下组织学观察,实验组仅有薄而松散的胶原纤维存在,成纤维细胞稀少,对照组有大量厚而致密的胶原纤维堆积,伴大量成纤维细胞。实验组成纤维细胞计数明显少于对照组,差异有显著性意义(P<0.01)。结论:A型肉毒毒素组膝关节纤维性粘连的程度明显低于对照组,说明A型肉毒毒素可以有效预防术后膝关节纤维性粘连。
BACKGROUND： Botulinum toxin type A （BTX-A） can prevent knee joints from fibrous adhesion via blocking the activation of interleukin 1. OBJECTIVE： To investigate the effects of intra-articular BTX-A in preventing knee joint from postoperative arthrofibrosis. DESIGN, TIME AND SETTING： A completely randomized controlled experiment with animals as subjects was performed at the Weifang Medical College and Weifang People＇s Hospital from July to October 2008. MATERIALS： BTX-A was provided by Lanzhou Institute of Biological Products, 20 New Zealand white rabbits, aged 4 months, weighing 2.8-3.2 kg, were randomly divided into the experimental and control groups, with 10 animals in each group. METHODS： Arthrofibrosis was induced in right stifle joint of 20 rabbits by transecting the anterior cruciate ligaments. At 1 week after operation, the knee joints were intra-articular injected BTX-A 0.6 mL （50 U） and physiologic saline solution 0.6 mL in the experimental group and control group, respectively, once per week for 3 times. MAIN OUTCOME MEASURES： All the stifle joints were evaluated at 6 weeks after operation via biomechanical determination, gross observation, semi-quantitative score and histological evaluation. RESULTS： Biomechanical measurement showed that the flexion contracture angle of the experimental group was significant smaller than the control group （P 〈 0.01 ）. The adhesion rate of knees and semi-quantitative score in the experimental group was significantly lower than the control group （P=0.005, P 〈 0.01 ）. The histological evaluation showed that there were loose fibrous tissues with a few of fibroblasts in the experimental group; however, there were dense fibrous tissue could be found in the control group. With regard to count of fibroblast, a significant reduction was observed in the experimental group compared with the control group, the difference had significance （P 〈 0.01）. CONCLUSION： The degree of knee fibrous adhesion was obvious lower in the BTX-A group, which demonstrated that BTX-A had efficacy in preventing arthrofibrosis after knee surgery.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第20期3929-3932,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
