摘要
目的聚乳酸(polylactic acid,PLA)补片具有适当空间构型、机械强度和柔韧性,通过医用胶黏贴PLA补片密封纤维环穿刺所留针孔,探讨其阻断纤维环穿刺后椎间盘内炎性反应的效果。方法取健康6月龄新西兰大白兔20只,体重2.0～2.5kg,随机分为4组(n=5)。假手术组(A组)仅显露L2～7水平椎体及椎间盘,作为对照;纤维环穿刺组(B组)用18G穿刺针穿刺L2～7纤维环全层;补片修补组(C组)及胶补组(D组)同上法穿刺后,分别用医用胶黏贴PLA补片及单纯医用胶封堵穿刺孔。术后观察动物一般情况,于1周后处死动物取椎间盘大体观察后,组织学染色观察髓核及内层纤维环形态,免疫组织化学染色及ELISA法检测椎间盘内IL-1β、TNF-α、诱导型一氧化氮合成酶(inducible nitric oxide synthase,iNOs)表达情况。结果术后各组动物均存活至实验完成。术后1周,A组椎间盘结构正常。B组穿刺针孔处有少量髓核组织溢出,此处纤维环与周围组织轻度粘连;组织学观察见髓核组织有明显退变表现。C、D组可见凝结成团块状的医用胶与周围组织广泛粘连;组织学观察见C组髓核组织形态与A组相似,而D组存在明显细胞减少,基质紊乱,与B组相似。ELISA检测示A、C组IL-1β、TNF-α、iNOs表达水平明显低于B、D组,差异均有统计学意义(P<0.05),A、C组间及B、D组间比较差异无统计学意义(P>0.05)。结论采用医用胶黏贴PLA补片修补纤维环穿刺针孔在术后1周能降低兔椎间盘内炎性反应水平。
Objective Polylactic acid （PLA） patch has proper steric configuration, sufficient mechanic strength, and flexibility, to investigate the blocking effect on the intra-discal inflammation after annulus puncture sticked by medical glue so as to seal the pinhole left after annulus puncture. Methods Twenty healthy New Zealand white rabbits （weighing 2.0-2.5 kg） were randomly divided into 4 groups （n=5）： groups A, B, C, and D. In group A, the rabbits underwent exposure of intervertebral disc and transverse process at L2-7 as a control; in group B, the rabbits received annulus puncture at L2-7 with an 18-gauge needle; and in groups C and D, the pinholes were sealed respectively with a PLA patch sticked with medical gel and medical gel alone after annulus puncture at L2-7. General condition of rabbits was observed after operation. The intervertebral disc tissue was harvested 1 week after operation. The tissue structure was observed by HE and Masson staining. And the expressions of inflammatory factors like interleukin 1β （IL-1β）, tumor necrosis factor α （TNF-α）, and inducible nitric oxide synthase （iNOs） were detected with immunohistochemistry and ELISA. Results All the animals survived till the end of the experiment. In group A at 1 week, the nucleus pulposus tissue had normal structure. In group B at 1 week, leak of nucleus pulposus from the pinhole and slight adhesion to the adjacent tissue could be seen, and the nucleus pulposus tissue had significant degenerative change by histological observation. In groups C and D, clots of coagulated medical gel and extensive adhesion to the adjacent tissue could be seen; histological observation suggested that the nucleus pulposus tissue of group C had similar histology manifestation to that of group A; while group D had similar histology manifestation to group B with obviously-decreased cells and disorder of matrix. ELISA test showed remarkably elevated expression level of inflammatory factors including IL-1β, TNF-α, and iNOs in groups B and D when compared with groups A and C, showing significant differences （P 〈 0.05）, and similar expression level were observed in groups A and C, groups B and D （P 〉 0.05）. Conclusion The PLA patch sticked with medical gel is effective in blocking the intra-discal inflammation 1 week after annulus puncture.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第10期1159-1163,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
国家自然科学基金资助项目(30973035)~~
关键词
纤维环穿刺
聚乳酸补片
炎性反应
椎间盘退变
兔
Annulus puncture Polylactic acid patch Inflammation Intervertebral discdegeneration Rabbit
