【摘要】 目的:通过单纯胚胎脊髓移植和胚胎脊髓大网膜双重移植两种方式,分析胎鼠脊髓移植物成活生长情况及形态学变化,为脊髓损伤找寻一条新的治疗途径。方法:实验于2000-01/2002-01在武汉科技大学附属博爱医院神经外科实验室完成。选取W istar大鼠90只,随机分为两组:单纯胚胎脊髓移植组48只,胚胎脊髓大网膜双重移植组42只。显微镜下造成两组鼠脊髓半侧损伤,取孕14d的胎鼠脊髓1.0～2.0m L移植于单纯胚胎脊髓移植组大鼠的脊髓损伤处,胚胎脊髓大网膜双重移植组在此基础上用大网膜覆盖于胚胎脊髓损伤处。术后14d将两组存活的实验鼠按Ducker’s评级方法进行瘫痪肢体功能测定(0级:完全瘫;1级:能自主运动,但不能支撑体质量;2级:能站立但不能行走;3级:能行走,但困难伴痉孪;4级:能跑,但有轻度共济失调;5级:正常运动)。分别于术后15,60,120d将大鼠断头处死,电镜观察移植物存活生长情况及形态学变化。结果:实验纳入大鼠90只,移植术后死亡43只,共47只大鼠进入结果分析。①术后14d两组大鼠移植物的存活率:单纯胚胎脊髓移植组有9只大鼠的移植物存活,存活率52.94%;胚胎脊髓大网膜双重移植组有26只大鼠的移植物存活,存活率86.67%,两组差异显著(P<0.05)。②术后14d两组大鼠瘫痪肢体的肌力恢复情况比较:单纯胚胎脊髓移植组移植物存活的9只鼠中仅有2只肌力恢复至Ⅰ～Ⅱ级,胚胎脊髓大网膜双重移植组移植物存活的26只鼠其肌力均得到恢复,其中18只恢复正常。③术后不同时间两组大鼠存活移植物的形态学变化:术后15d,电镜下移植物内神经细胞生长分化,细胞器增多,结构正常,生长旺盛,并见幼稚神经元发出的粗大神经生长锥;术后120d则演变为成熟神经元,移植物与宿主有血管沟通现象及新生血管和新髓鞘形成。结论:胚胎脊髓大网膜双重移植治疗脊髓损伤的效果明显优于单纯胚胎脊髓移植,大网膜移植是移植物成活生长及肢体肌力功能恢复的重要因素,提示胚胎性神经组织移植在中枢神经系统损伤的治疗中具有独特作用。更多还原

【Abstract】 AIM: To analyze the survival and growth as well as the morphological changes of embryonic spinal cord in fetal rats by means of only embryonic spinal cord transplantation and together with greater omentum double transplantation, so as to seek a new therapeutic pathway for spinal injury.METHODS: The experiment was carried out in the laboratory of neurosurgery department of the Boai Hospital affiliated to Wuhan University of Science and Technology between January 2001 and January 2002. Ninety Wistar rats were randomly divided into two groups: only embryonic spinal cord transplantation group (n=48) and together with greater omentum transplantation group (n=42). The rats were made into models of unilateral acute spinal cord injury with microsurgery technique. The spinal cord (1.0-2.0 mL) extracted from 14-day pregnant rats was grafted to the injured sites of spinal cord to all the rats, besides, the injured sites were covered with greater omentum in the together with greater omentum double transplantation group. At 14 postoperative days, the paralytic limbs’function of the survived rats were evaluated with the Ducker’s method (grade 0: pamplegia grade 1: automatic action but could not support the body mass grade 2: could stand but could not walk grade 3: could walk but with difficulty and accompanied by spasm grade 4: could run accompanied by mild incoordination grade 5: normal movement). The rats were killed by removing head at 15, 60 and 120 days after transplantation respectively, the survival and growth as well as the morphological changes of the grafts were observed under electron microscope. RESULTS: Totally 90 rats were used in the experiment, 43 died after the transplantation, finally 47 rats were involved in the analysis of results. ① The survival rate of grafts at 14 days after transplantation: The grafts survival in 9 rats (52.94%) of the only embryonic spinal cord transplantation group and 26 rats (86.67%) of the together with greater omentum transplantation group, and there was significant difference between the two groups (P < 0.05). ② Comparison of the recovery of paralytic limbs’muscle forces at 14 days after transplantation between the two groups: only the muscle force of 2 rats among the 9 survived rats in the only embryonic spinal cord transplantation group recovered to grade Ⅰ-Ⅱ, but recovered all in all the 26 survived rats of the together with greater omentum transplantation group, and recovered to the normal level in 18 of them. ③ Morphological changes of the survived grafts at different time after transplantation: At 15 days after transplantation, it was observed under electron microscope that there was nerve cell growth and differentiation in the grafts, organells were increased, structure was normal, growth was productive, and bulky nerve growing tips from immature neuron were seen, and developed to mature neurons at 120 days, there were vascular link up and vascularization and myelinization in the grafts and hosts. CONCLUSION: The effect of embryonic spinal cord and greater omentum double transplantation in the treatment of spinal injury is obviously superior to that of only embryonic spinal cord transplantation. Greater omentum transplantation is the important factor for the survival and growth of grafts and the functional recover of limbs’muscle force, indicating that embryonic nerve tissue transplantation plays a unique role in the treatment of central nervous system injury.更多还原