猕猴组织工程化周围神经移植物的实验研究

目的 评价利用化学萃取法获得的神经支架制备猕猴组织工程化周围神经移植物修复40mm尺神经缺损的效果。方法 共使用成年猕猴9只，随机取其中的6只，培养自体雪旺细胞，应用已经制备好的去细胞神经为支架材料构建组织工程化周围神经移植体修复猕猴尺神经的40mm缺损。实验分实验组，空白组，正常对照组3组。术后5个月通过形态学，肌电检测和免疫组织化学方法观察。结果 3组均未发现猕猴双手有糜烂或溃疡形成，猕猴小鱼际肌群的饱满度和弹性于术前无明显差别。实验组与正常对照组间小鱼际肌群的运动动作电位潜伏期．最大振幅及再生神经纤维的数目差异均无统计学意义（P〉0．05）。但在实验组与空白组间的差异有统计学意义（P〈0．05）。结论 用自体源雪旺细胞微注入去细胞同种异体神经支架构建的组织工程化神经移植物修复猕猴40mm的尺神经缺损，可取得与自体神经移植相似的效果。

Experimental studies of tissue-engineered nerve grafts in rhesus

Objective To evaluate the effect of tissue-engineered peripheral nerve grafts for repairing 40 mm ulnar nerve defect in a rhesus model. Methods Bilateral ulnar nerve defect was created in 9 rhesus rendering 18 nerve gaps which were divided into three groups randomly. 6 nerve gaps were bridged by chemical extracted allogenic nerve graft (ANC) implanted with autologous Schwann cells (SCs) (experiment group). Another 6 nerve gaps were repaired using ANC without SCs supplement (blank group). The rest 6 nerve gaps were bridged with autologous nerve graft to serve as control. Five months postoperatively morphology, electromyogram, HE staining, and neurofilament immunohistochemistry staining were carried out. Results No ulcer was seen on the monkeys' hands. Hypothenar prominence of the hands in 3 groups did not show significant differences. The differences of the latent period and amplitude of compound muscle action potential, and the number of regenerating nerve fibers were not statistically significant between the experiment group and the normal control. The differences of these parameters, however, were significant between the experiment group and the blank group. Conclusion 40 mm-long defect of the ulnar nerve can be repaired by chemical extracted allogenic nerve graft implanted with cultured autologous SCs. Nerve regeneration of using this graft is comparable to that of autologous nerve graft.