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背景:碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)能促进体外腱细胞的增殖及胶原分泌,并促进鞘外肌腱的愈合,但其对鞘内肌腱的作用的资料较少。目的:探讨外源性bFGF对鞘内肌腱愈合和粘连形成的作用。设计、时间及地点:随机对照动物实验,于2004-05/2005-02在上海市第六人民医院实验动物中心实验室完成。材料:成年雄性来亨鸡90只制备鸡右爪第3趾趾深屈肌腱横断模型,随机均分为3组,每组30只。方法:对照组:肌腱横行切断后原位修复。纤维蛋白封闭剂组:在肌腱断端使用纤维蛋白封闭剂0.6μL后,原位修复肌腱。bFGF组:在断端使用bFGF和内含bFGF 500 ng的纤维蛋白封闭剂混合物0.6μL,原位修复肌腱。主要观察指标:术后1,2,4,8周,每组各取6只鸡进行大体、组织学检测;术后8周每组再取6只鸡进行生物力学测定。结果:对照组与纤维蛋白封闭剂组间各项观测指标比较均无显著性差别,与对照组和纤维蛋白封闭剂组相比,bFGF组修复部位腱鞘、腱外膜及腱实质的新生血管形成、成纤维细胞增殖较好,胶原的分泌出现早,数量也较多;肌腱滑动距离较短,屈曲功和肌腱最大抗拉力较大。结论:在肌腱断端使用外源性bFGF能促进鞘内肌腱的愈合,但也加重了肌腱的粘连。
BACKGROUND: Basic fibroblast growth factor (bFGF) promotes the proliferation and collagen secretion of tendon cells in vitro and promotes the healing of the sheath of the sheath. However, its effect on the intrathecal tendon is poorly documented. Objective: To investigate the effect of exogenous bFGF on the healing and adhesion of intrathecal tendon. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Laboratory of Laboratory Animal Center, the Sixth People's Hospital of Shanghai, from May 2004 to February 2005. MATERIALS: Ninety male adult Leghorn chickens were randomly divided into 3 groups (30 in each group). Methods: The control group: the tendon was cut off and repaired in situ. Fibrin Sealant Group: Tendons were repaired in situ after using 0.6 μL of fibrin sealant at the tendon stump. bFGF group: 0.6 μL of bFGF and a fibrin sealant mixture containing 500 ng of bFGF at the stump were used to repair the tendon in situ. MAIN OUTCOME MEASURES: At 1, 2, 4, and 8 weeks after operation, 6 chickens in each group were subjected to gross and histological examination. Six rabbits in each group after 8 weeks were biomechanically measured. Results: There was no significant difference between the control group and the fibrin sealant group. Compared with the control group and fibrin sealant group, the neovascularization of the tendon sheath, tendon adventitia and tendon parenchyma in the bFGF group , Fibroblast proliferation is better, the secretion of collagen appears earlier, the number is also more; tendon sliding short distance, flexion and tendon maximum tensile strength larger. Conclusion: The use of exogenous bFGF at the tendon stump promotes the healing of intrathecal tendons but also aggravates tendon adhesions.