丝裂霉素C预防大鼠椎板切除后硬膜外粘连的量效关系及安全性

The dose-effect relationship and safety of topical mitomycin C in preventing postlaminectomy peridu?鄄ral adhesion in rats

中文关键词:  椎板切除术  硬膜  粘连  丝裂霉素C  量效关系  安全性  大鼠

英文关键词:Laminectomy  Peridural adhesion  Mitomycin C  Dose-effect relationship concentration  Security  Rat

中文摘要:

  【摘要】 目的：探讨丝裂霉素C（MMC）预防大鼠椎板切除后硬膜外粘连的量效关系及其使用安全性。方法：60只SD大鼠随机分成5组，每组12只。分别切除L1椎板，术中各组分别以棉片浸透生理盐水（A组）或0.1mg/ml（B组）、0.3mg/ml（C组）、0.5mg/ml（D组）、0.7mg/ml（E组）的MMC，置于裸露的硬脊膜后方5min。A组应用生理盐水前后及B、C、D、E组应用MMC前后分别测定其体感诱发电位（SEP）潜伏期。术后4周处死大鼠，切取手术段脊柱，肉眼观察硬膜外粘连程度，行硬膜外瘢痕组织羟脯氨酸（HOP）含量测定、胶原组织面积测定及成纤维细胞计数。结果：A组应用生理盐水前后及B、C、D、E组应用MMC前后SEP潜伏期无明显改变。D、E组与A、B、C组比较硬脊膜与后方瘢痕组织粘连变轻，HOP含量降低，胶原面积减少，成纤维细胞计数减少，差异均有统计学意义（P<0.05）。B、C组与A组比较硬脊膜与后方瘢痕组织粘连变轻，HOP含量降低，成纤维细胞计数减少，差异均有统计学意义（P<0.05），胶原面积差异无统计学意义（P＞0.05）。D、E两组间及B、C两组间各项指标差异均无统计学意义（P＞0.05）。结论：0.5mg/ml浓度的MMC对预防大鼠椎板切除后硬膜外粘连具有较好的量效关系，且使用安全。

英文摘要:

  【Abstract】 Objective：To investigate the dose-effect relationship and safety of topical mitomycin C（MMC） in preventing postlaminectomy peridural adhesion in rats.Method：Laminectomy was performed at L1 in 60 rats，cotton pads soaked either with 0.1mg/ml（group B），0.3mg/ml（group C），0.5mg/ml（group D），0.7mg/ml（group E） MMC，or saline（group A） were filled into the operative sites for five minutes.The latent period of the somatosensory evoked potential（SEP） before and after administration in each group was tested．The rats were sacrificed 4 weeks after surgery.Then the degree of scar adhesion in each specimen was evaluated by Rydell method，the content of hydroxyproline（HOP），the area of peridural fibrosis formation and the count of fibroblasts were tested.Result：The latent period of SEP did not change obviously before and after administration in each group．The peridural adhesion，the content of HOP，the area of peridural fibrosis formation and the count of fibroblasts in group D，E decreased significantly compared with group A，B and C（P<0.05）.The peridural adhesion，the content of HOP and the count of fibroblasts in group B，C decreased significantly compared with group A（P<0.05），and no statistical difference with respect to the area of peridural fibrosis was noted（P＞0.05）.There was no statistical difference between group B and C，or between group D and E（P＞0.05）．Conclusion：0.5mg/ml MMC has the best dose-effect relationship and safety in preventing postlaminectomy peridural adhesion in rats．