肝细胞生长因子可修复喉返神经损伤

2012-12-21 佚名 听力学及言语疾病杂志

     喉返神经损伤后,再生的轴突数目不足及功能恢复不佳是影响喉功能恢复的重要原因。应用神经营养因子等生物活性因子促进神经轴突的再生, 近年来已成为周围神经损伤修复研究中的一项重要突破。肝细胞生长因子(HGF ) 广泛分布于全身各组织器官,是一种多效性细胞因子, 具有多种功能。已有研究证实HGF 对中枢神经系统有保护作用 ,&n

  

  喉返神经损伤后,再生的轴突数目不足及功能恢复不佳是影响喉功能恢复的重要原因。应用神经营养因子等生物活性因子促进神经轴突的再生, 近年来已成为周围神经损伤修复研究中的一项重要突破。肝细胞生长因子(HGF ) 广泛分布于全身各组织器官,是一种多效性细胞因子, 具有多种功能。已有研究证实HGF 对中枢神经系统有保护作用 , 在坐骨神经 、舌下神经 及面神经等周围神经损伤后, 局部给予外源性HGF 对神经元有保护作用并对轴突再生和诱向生长具有促进作用。HGF 对喉返神经损伤后修复的作用尚未见相关报道。本研究通过制造犬单侧喉返神经损伤动物模型后, 用聚乳酸聚羟基乙酸共聚物(PLGA)管桥接喉返神经断端, 并在局部应用外源性HGF , 观察其对受损喉返神经再生及功能恢复的作用。

  研究表明,喉返神经损伤后应用外源性HGF 对其再生有明显的促进作用。

  研究者选取20 只健康杂种犬分成HGF 组及对照组, 每组10 只。每只犬切断左侧喉返神经后, 用聚乳酸聚羟基乙酸共聚物(PLGA)桥接左侧喉返神经断端, HGF 组于PLGA 管内及局部应用HGF , 对照组同法应用等量生理盐水。于术后2、3、4个月分别行电子喉镜、喉返神经电生理检查, 最后一次检查完后处死动物, 取神经干作神经组织学和超微结构观察。

  结果发现,术后2 个月, 两组动物术侧声带未恢复运动; 术后3个月, HGF 组有4 只犬的左侧声带观察到内收、外展运动, 而对照组均未恢复运动; 术后4 个月, HGF 组存活的8只犬中7 只术侧声带恢复运动, 对照组7 只存活犬中5 只术侧声带恢复运动, 但运动幅度均明显小于HGF 组。术后各时间点HGF 组与对照组喉返神经电生理检查结果相比较, HGF 组自发肌电图、诱发电位幅度明显增大, 潜伏期明显缩短, 差异均有统计学意义(P <0 .05 )。HGF 组有髓再生神经纤维数、神经纤维的直径及髓鞘的厚度均明显大于对照组, 差异均有统计学意义(P <0 .05 )。电镜观察示HGF 组的再生神经纤维超微结构形态接近正常, 而对照组形态与正常差异较大, 可见较多的无髓神经纤维。

  原文出处:2012年第5卷第10期《听力学及言语疾病杂志》肝细胞生长因子对喉返神经损伤后再生的作用

    

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    2013-02-17 xjy02
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