高三尖杉酯碱对大鼠椎板切除术后硬膜外粘连的影响

The study of the effect and safety of homoharringtonine in the prevention of postlaminectomy epidural adhesion in rats

中文关键词:  椎板切除术  大鼠  高三尖杉酯碱  硬膜外粘连  安全性

英文关键词:Laminectomy  Rat  Homoharringtonine  Epidural adhesion  Safety

中文摘要:

  【摘要】 目的：探讨局部应用不同浓度高三尖杉酯碱（homoharringtonine，HHT）对L1椎板切除术后大鼠硬膜外瘢痕粘连的预防效果。方法：将36只成年雄性SD大鼠，2月龄，体重279.42±32.58g（260～320g），随机分成A组（HHT 0.2mg/ml组）、B组（HHT 0.1mg/ml组）、C组（生理盐水组）。制作L1椎板切除术模型，显露硬脊膜，C组生理盐水冲洗后直接逐层闭合切口，A、B组分别用浸泡有不同浓度HHT的棉垫放入骨缺损区5min，生理盐水冲洗后再逐层闭合切口。术后1个月时，行大体标本及组织病理学（HE染色）观察硬膜外瘢痕粘连情况，并使用Image Pro Plus软件进行成纤维细胞计数以及胶原光密度值分析。结果：A组无明显粘连，B组存在轻度粘连，C组形成紧密的硬膜外瘢痕粘连。A组硬膜外瘢痕中胶原光密度值（0.063±0.014）及成纤维细胞计数（8.43±2.52个）较C组（0.186±0.005和22.47±2.37个）明显降低，且优于B组（0.126±0.017和14.60±1.67个）（P＜0.05）。结论：局部应用高三尖杉酯碱对预防硬膜外粘连有效，可减少椎板切除术后瘢痕形成。且局部应用0.2mg/ml的高三尖杉酯碱防粘连效果更佳。

英文摘要:

  【Abstract】 Objectives: To determine the effect of local application of the homoharringtonine(HHT) in preventing postlaminectomy epidural adhesion in rats. Methods: A total of 36 adult male SD rats, aged 2 months and weight 279.42±32.58g(260-320g), were selected and randomly divided into group A(HHT 0.2mg/ml group), group B(HHT 0.1mg/ml group), and group C(normal saline group). The L1 laminectomy model was made and the dural membrane was exposed. In group C, the wound was closed layer by layer after normal saline irrigation. In groups A and B, cotton pads with different concentrations of HHT were soaked into the bone defect area for 5min, and then the wound was closed layer by layer after normal saline irrigation. At 1 month after surgery, gross specimens and histopathology(HE staining) were used to observe the condition of epidural scar adhesion, and the fibroblast count and collagen optical density were analyzed by Image Pro Plus. Results: There were no obvious adhesions in group A, mild adhesions in group B, and tight epidural scar adhesions in group C. The collagen optical density and fibroblast count in epidural scar in group A was 0.063±0.014 and 8.43±2.52 respectively, which were significantly lower than that in group C(0.186±0.005 and 22.47±2.37), and were better than that in group B(0.126±0.017 and 14.60±1.67)(P<0.05). Conclusions: Topical application of homoharringtonine has a good effect in preventing postlaminectomy epidural adhesion.