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目的观察壳聚糖复合他克莫司(FK506)缓释鞘管结合3mm小间隙桥接神经对神经再生的影响。方法将45只雄性SD大鼠,随机分成3组,切断双侧坐骨神经制成坐骨神经再生室模型,并保留断端间隙为3mm。实验所用得桥接材料分别是:硅胶管、壳聚糖鞘管、壳聚糖复合FK506缓释鞘管。分别于术后6、8、12周观察桥接材料周围的瘢痕形成及吸收情况,并行神经电生理、组织学观察、图象分析、腓肠肌湿重检测比较各组大鼠坐骨神经的再生与功能恢复情况。结果术后大体标本观察显示:对照组再生室与周围组织粘连较重;壳聚糖鞘管组、壳聚糖复合FK506鞘管组神经桥接处较易与周围组织剥离,粘连轻微。6周时各组再生室均尚存;8周时壳聚糖鞘管组、壳聚糖复合FK506鞘管组桥接材料开始吸收;12周时壳聚糖鞘管组、壳聚糖复合FK506鞘管组桥接材料不完整或仅有碎片残留,神经连续性建立,且与周围组织无明显粘连。评估神经再生的运动神经传导速度、复合肌肉动作电位、潜伏期检测指标,壳聚糖复合FK506鞘管组(10.2m/s±0.8m/s、4.3mV±0.3mV、1.9ms±0.4ms)明显优于对照组(4.2ms±0.5ms、1.2mV±0.3mV、7.5ms±0.4mV)、壳聚糖鞘管组(9.5ms±0.3ms、2.7mV±0.3mV、3.1ms±0.4ms),P<0.05。壳聚糖鞘管组虽然各指标均数优于对照组,但之间差异无统计学意义。结论应用壳聚糖复合FK506缓释鞘管桥接大鼠坐骨神经,在体内稳定2个月以上开始降解,能够明显促进神经再生与功能恢复,且降解产物为多糖类,不影响神经再生微环境。
Objective To observe the effect of chitosan combined with sustained-release sheath of tacrolimus (FK506) combined with 3mm small gap bridging nerve on nerve regeneration. Methods Forty five male Sprague-Dawley rats were randomly divided into three groups. The bilateral sciatic nerve was cut into sciatic nerve regeneration model and the gap between the two ends was 3 mm. Experimental materials used in the bridge are: silicone tube, chitosan sheath, chitosan composite FK506 sustained release sheath. The formation and absorption of scar around the bridging material were observed at 6, 8 and 12 weeks after operation. Neuroendroglial and histological observation, image analysis and gastrocnemius muscle wet weight test were performed to compare the regenerative and functional recovery of sciatic nerve . Results The postoperative gross specimen observation showed that the regenerative compartment of the control group had a stronger adhesion with the surrounding tissues. The chondrosarcoma sheath group and the chitosan composite FK506 sheath tube group were more likely to peel off from the surrounding tissue with lesser adhesion. At 6 weeks, the regeneration chamber of each group survived. At 8 weeks, the chitosan sheath group and chitosan composite FK506 sheath group began to absorb the bridging material. At 12 weeks, chitosan sheath group, chitosan composite FK506 sheath Tube group bridge material is incomplete or only debris left, nerve continuity established, and no obvious adhesion with the surrounding tissue. Evaluation of motor nerve conduction velocity, composite muscle action potential, latency detection index, Nerve regeneration in the chondroitin composite FK506 sheath group (10.2m / s ± 0.8m / s, 4.3mV ± 0.3mV, 1.9ms ± 0.4ms) Which was better than the control group (4.2ms ± 0.5ms, 1.2mV ± 0.3mV, 7.5ms ± 0.4mV), chitosan sheath group (9.5ms ± 0.3ms, 2.7mV ± 0.3mV, 3.1ms ± 0.4ms) P <0.05. Chitosan sheath group although the average number of indicators better than the control group, but the difference was not statistically significant. Conclusions Chitosan composite FK506 sustained-release sheath bridges the sciatic nerve of rats and begins to degrade in vivo for more than 2 months. It can significantly promote nerve regeneration and functional recovery, and the degradation products are polysaccharides without affecting the nerve regeneration microenvironment.