摘要
目的探讨鞘内保留残端(保残)重建术与牵张保残重建术对兔前交叉韧带(ACL)残端成纤维细胞增殖、凋亡的影响。方法将43只新西兰兔随机分为A组3只、B组8只、C组16只、D组16只。B组单纯切断双侧ACL,C组切断ACL后给予残端鞘内重建术,D组切断ACL后给予牵张保残重建术,术后3、6周,取其ACL残端标本。A组作为正常对照选两侧后肢正常ACL标本(胫骨端4 mm)。各标本HE染色观察残端内成纤维细胞数量,免疫组化法检测残端内成纤维细胞中增殖细胞相关核抗原(Ki-67)蛋白表达,TUNEL法检测残端内成纤维细胞凋亡。结果术后3、6周,B、C、D组ACL残端内成纤维细胞数量均多于A组(P均<0. 05),B、C、D组比较差异无统计意义(P> 0. 05);术后6周,B、C、D组成纤维细胞数量较术后3周减少,但仍高于A组(P <0. 05),B、C、D组比较差异无统计意义(P> 0. 05)。术后3、6周,B、C、D组残端成纤维细胞内Ki-67蛋白表达、凋亡率比较差异无统计学意义(P均> 0. 05)。结论残端鞘内重建、牵张保残重建两种术式均未促进兔ACL残端成纤维细胞生长,二者对成纤维细胞增殖和凋亡的影响无差异。
Objective To investigate the effects of different methods of anterior cruciate ligament reconstruction with remnant preservation( intrathecal ACL reconstruction in the preserved remnants and ACL remnant femoral tensioning and augmented suture technique) on the proliferation and apoptosis of fibroblasts in the preserved remnants of rabbit anterior cruciate ligament( ACL). Methods Forty-three New Zealand rabbits were randomly divided into four groups: groups A( n = 3),B( n = 8),C( n = 16),and D( n = 16). The right knee ACL reconstruction was performed in the rabbits of groups C( with intrathecal ACL reconstruction in the preserved remnants) and D( with ACL remnant femoral tensioning and augmented suture technique) after cutting ACL. At 3 and 6 weeks after surgery,ACL remnants were taken as specimens. In the group A,we selected the normal ACL of the hind limbs( 4 mm of the tibial end) as the control group. The proliferation and apoptosis of fibroblasts in the tibia stump were observed by HE,Ki-67 immunohistochemical staining and TUNEL apoptosis. Results The number of fibroblasts in the ACL tibial stump of groups B,C and D were higher than that of group A at 3 and 6 weeks after operation( all P < 0. 05),and there was no significant difference between group C and D( P > 0. 05). There were no significant differences in ki-67 protein expression and apoptosis rate between the groups B,C and D at 3 and 6 weeks after operation( all P > 0. 05). Conclusion Two methods of ACL reconstruction with remnant preservation failed to promote the growth of fibroblasts in ACL stump in rabbits,and both of them had no effect on the proliferation and apoptosis of fibroblasts.
引文
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