复合他克莫司聚乳酸-乙醇酸缓释导管修复大鼠胫神经缺损

背景：虽然单纯聚乳酸-乙醇酸导管修复大鼠神经缺损可部分恢复大鼠神经功能,但神经直径、再生纤维数量、髓鞘成熟度及功能恢复上均较自体神经移植差。目的：观察复合他克莫司的聚乳酸-乙醇酸缓释导管修复大鼠胫神经缺损的可行性。方法：制作SD大鼠右侧胫神经缺损模型,随机分为3组,分别植入自体胫神经、单纯聚乳酸-乙醇酸导管及复合他克莫司的聚乳酸-乙醇酸缓释导管修复。植入后3,6,12周行坐骨神经功能指数检查、电生理检查、组织学观测、腓肠肌湿质量测量。结果与结论：植入后第6,12周复合他克莫司的聚乳酸-乙醇酸缓释导管组、自体胫神经组坐骨神经功能指数检查、电生理检查、组织学观测、腓肠肌湿质量测量结果优于单纯聚乳酸-乙醇酸导管组(P < 0.05),自体胫神经组、复合他克莫司的聚乳酸-乙醇酸缓释导管组比较差异无显著性意义。说明复合他克莫司的聚乳酸-乙醇酸缓释导管桥接修复大鼠胫神经缺损可明显促进断端神经的再生,在晚期功能恢复上取得接近自体神经移植的效果。关键词：聚乳酸-乙醇酸;他克莫司;神经导管;大鼠;坐骨神经doi:10.3969/j.issn.1673-8225.2012.12.003

Repair of tibial nerve defects by tacrolimus sustained-release poly (lactic-co-glycolic acid) conduits in rats

BACKGROUND: Although the peripheral nerve function of rats with nerve defects can be partially recovered following repair with poly(lactic-co-glycolic acid) conduits, the regenerated nerve is smaller in diameter and contains less nerve fibers compared with autogenous nervegrafting, as well as the maturity of the myelin and functional recovery cannot be compared with autogenous nerve grafting either.OBJECTIVE: To observe the feasibility of tacrolimus sustained-release poly (lactic-co-glycolic acid) conduits for repair of tibial nerve defects in rats.METHODS: The SD rat models of right tibial nerve defects were established and divided into three groups randomly. The tibial nerve defect was repaired with autogenous tibial nerve, poly (lactic-co-glycolic acid) conduits and tacrolimus sustained-release poly (lactic-co-glycolic acid) conduits respectively in each group. The tibial nerve regeneration and functional recovery were observed by sciatic functional index assessment, electrophysiologic study, histological examination and the measurement of gastrocnemius wet weight at weeks 3, 6, and 12 postoperatively.RESULTS AND CONCLUSION: The sciatic functional index assessment, electrophysiologic study, histological examination, as well as the measurement of gastrocnemius wet weight indicated that the nerve regeneration and functional recovery of autograft group and tacrolimus sustained-release poly (lactic-co-glycolic acid) conduits group had better results than that of poly (lactic-co-glycolic acid) conduits group at weeks 6 and 12 postoperatively (P < 0.05). There was no significant difference between autograft group and tacrolimus sustained-release poly (lactic-co-glycolic acid) conduits group. It suggests that tacrolimus sustained-release poly (lactic-co-glycolic acid) conduits for the repair of tibial nerve defects can promote nerve regeneration obviously and have a better effect on the functional recovery at advanced stage, which is similar to nerve autografts.