【作者】 苏俊波；

【导师】 骆文龙；

【作者基本信息】 重庆医科大学 ， 耳鼻咽喉科学， 2004， 硕士

【摘要】 目的:近来国外研究发现肝细胞生长因子（HGF）具有神经营养样作用。而面神经损伤无论在平时还是战时均是多见的疾病，损伤后，尤其是离断后，成功的显微外科技术对修复虽然重要，但不能解决神经错向生长等问题，需行生物修复，且面神经的功能恢复最终要靠运动终板的修复，故本研究以新西兰家兔面神经硅胶生物再生室为模型，研究肝细胞生长因子（HGF）对面神经损伤后运动终板及肌纤维修复作用的影响,为临床寻找一种方便、有效的神经营养因子，创造一个良好的神经再生微环境提供初步的实验依据。 方法：实验设生理盐水对照组和肝细胞生长因子组，选用24只成年、健康新西兰家兔，暴露并分离双侧面神经颊支，将其横断后套入硅胶管内，用显微外科技术将硅胶管与神经外膜缝合以形成硅胶生物再生室，左侧再生室内注入HGF为实验侧，右侧注入生理盐水为对照<WP=7>侧，于术后6周、12周分批取面神经颊支所支配的肌组织，行乙酰胆碱酯酶染色和HE染色以显示运动终板及肌纤维，进行组织形态学观察和形态定量分析。结果：术后6周实验侧终板形态比对照侧规则，着色更深，具有显著性差异（P＜0.01），肌纤维横截面积无显著性差异（P＞0.05）。术后12周实验侧终板形态接近正常，对照侧终板结构不成熟，染色深浅具有显著性差异（P＜0.01），实验侧肌纤维比对照侧粗，其横截面积具有显著性差异（P＜0.01）。结论：本研究初步表明在面神经硅胶生物再生室内外源性追加HGF对其运动终板及肌纤维的修复有促进作用，但具体的作用机制有待于进一步的研究。更多还原

【Abstract】 Objective: Hepatocyte growth factor (HGF) exhibited properties on different types of neurons, including motor, sensory and parasympathetic neurons. Facial nerve (FN) injury was a common disease in practice medicine, successful microsurgery technic and microenviroment were equally essential for peripheral nerve regeneration .But there exited some problem and repairs of injured facial nerve needed biologic repair . Function repair of injured facial nerve finally depended on repair of motor end-plate. So our study was to establish the FN transected model, in which the buccal division of FN of adult New Zealand rabbit was transected and a nerve growth chamber created to elucidate the role of HGF in the regeneration of motor end-plate and myofiber of injured facial nerve.Methods: The buccal branches of facial nerve were exposed and transected, a nerve growth chamber were created by suturing the epineurium and silicone chamber under microscope .The chambers of experimental sides(left sides of facial nerve) were injected with HGF/normal saline and that of the control sides with normal saline of <WP=9>same amount (10μL ) .The acetylcholinesterase (AchE) in the motor end-plate and the myofiber of injured facial nerve were analysed by using histochemical staining and image analysis techique ofter 6 and 12 weeks of operation.Results: Histochemical analysis of MEP AchE staining showed the color of MEP on HGF side was deeper than that on control side,and there was significan difference of the color of MEP between HGF and control sides after 6 and 12 weeks of operation (P<0.01).The structure of MEP on HGF side looked near normal ,while on control side it was still unmature after 12 weeks of operation.The area of the myofiber cross section on HGF side was bigger than that on control side, and there was significan difference of the area of myofiber cross section between HGF and control sides after 12 weeks of operation (P<0.01).But there was no significan difference of the area after 6 weeks of operation (P＞0.05). Conclusion: HGF within a silicone chamber enhanced the recover of MEP and myofiber in New Zealand rabbits . But recovery of metabolism of HGF needed more experiment.更多还原