Zhang Yu, Zhou Chusong, Jiang Gangbiao, Gao Fei, Fu Dong
Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou Guangdong 510282, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Oct;22(10):1222-6.
To investigate the therapeutic effect of the chitosan/polyethylene glycols-succinate/ mitomycin C (CH/PEG-SA/MMC) film on epidural scarring tissues.
According to a specific proportion of respective materials, the film of CH/PEG-SA/MMC was developed under some condition. Thirty SD rats were selected and randomized into 6 groups with 5 rats in each group. A rat model of lumbar laminectomy was used. The amount of 20 mg of the CH film was implanted into the animals in group I, 20 mg of CH/PEG film in group II, 20 mg of CH/PEG-SA film in group III, 0.05 mg/mL of the MMC soaking for 5 minutes in group IV, 20 mg of CH/PEG-SA/MMC film in group V, and nothing was done in group VI. Specimens were harvested 4 weeks after the above procedures and were then subjected to immunohistochemical and histological examinations to compare their therapeutic effects on epidural cicatricial tissues.
All rats were in good conditions after operation, without gait abnormality, restlessness, infection and death. There was no significant difference among the 6 groups in the postoperative Rydell score (P < 0.05). The content of hydroxyproline in groups I, II, III, IV, V and VI was (0.570 8 +/- 0.345 0), (0.728 6 +/- 0.150 6), (0.553 4 +/- 0.122 3), (0.313 3 +/- 0.106 4), (0.261 9 +/- 0.102 1) and (1.020 1 +/- 0.120 6) microg/mg, respectively. There was a significant difference between groups IV, V and groups I, II, III (P < 0.05), and there was significant difference between group VI and the rest 5 groups (P < 0.05). According to the histological observation, group V had less collagenous fiber paralleling the dura mater, with few inflammatory cells infiltration, with few capillary vessels and no reaction of macrophages.
CH/PEG-SA/MMC films can effectively reduce the amount of Hyp in epidural scarring tissues after lumbar laminectomy and therefore is a good treating method in preventing scarring tissue adhesion.
探讨壳聚糖/聚乙二醇琥珀酸酯/丝裂霉素C（CH/PEG-SA/MMC）膜对硬膜外瘢痕组织的治疗作用。
按照各材料的特定比例，在一定条件下制备CH/PEG-SA/MMC膜。选取30只SD大鼠，随机分为6组，每组5只。采用大鼠腰椎椎板切除术模型。I组动物植入20mg CH膜，II组植入20mg CH/PEG膜，III组植入20mg CH/PEG-SA膜，IV组用0.05mg/mL丝裂霉素C浸泡5分钟，V组植入20mg CH/PEG-SA/MMC膜，VI组不做处理。上述操作4周后取材，进行免疫组织化学和组织学检查，比较其对硬膜外瘢痕组织的治疗效果。
所有大鼠术后情况良好，无步态异常、烦躁不安、感染及死亡。6组术后Rydell评分差异无统计学意义（P<0.05）。I、II、III、IV、V、VI组羟脯氨酸含量分别为（0.570 8±0.345 0）、（0.728 6±0.150 6）、（0.553 4±0.122 3）、（0.313 3±0.106 4）、（0.261 9±0.102 1）和（1.020 1±0.120 6）μg/mg。IV、V组与I、II、III组之间差异有统计学意义（P<0.05），VI组与其余5组之间差异有统计学意义（P<0.05）。组织学观察显示，V组平行于硬脊膜的胶原纤维较少，炎性细胞浸润少，毛细血管少，巨噬细胞无反应。
CH/PEG-SA/MMC膜能有效降低腰椎椎板切除术后硬膜外瘢痕组织中羟脯氨酸含量，是预防瘢痕组织粘连的良好治疗方法。
