羟基喜树碱和丝裂霉素C预防椎板切除术后硬膜外瘢痕粘连的研究
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江苏省卫生厅医学重点人才资助(NO60)


The effect of hydroxycamptothecin and mitomycin C in reducing epidural scar adhesion after lumbar laminectomy
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    摘要:

    目的:比较局部应用羟基喜树碱(hydroxycamptothecin,HCPT)和丝裂霉素C(mitomycin C,MMC)预防腰椎板切除手术后硬膜外瘢痕粘连的效果。方法:30只SD大鼠制作L1椎板切除模型。随机分成3组,HCPT组以棉片浸透0.1 g/LHCPT,MMC组以棉片浸透0.1 g/L MMC,对照组以棉片浸透生理盐水置于裸露的硬脊膜后5 min,检测用药前后体感诱发电位(SEP)的变化。术后4周分别行大体标本观察、组织病理染色和MRI检查,采用计算机图像分析进行成纤维细胞计数和硬膜外瘢痕面积测量。结果: HCPT组存在轻度粘连,MMC组无明显粘连,对照组形成紧密的硬膜外瘢痕粘连。用药前后各组SEP检测无显著性差异,HCPT组和MMC组成纤维细胞计数和硬膜外瘢痕面积均较对照组明显降低。结论:局部短时应用HCPT可减少椎板切除术后瘢痕形成,有效预防硬膜外粘连,但MMC较HCPT有更好的效果。

    Abstract:

    Objective:To compare the effect of topical application of hydroxycamptothecin(HCPT) and mitomycin C(MMC) in preventing postlaminectomy epidural adhesion. Methods:Laminectomies were performed at L1 on 30 rats. Cotton pads soaked with 0.1 g/L HCPT, 0.1 g/L MMC or saline were applied to the operative sites for 5 min. Somatosensory evoked potential(SEP) was detected before or after administration. The effects of epidural adhesion after 4 weeks were observed with macroscopic observation,histopathological evaluation and MRI scanning. The count of fibroblasts and the area of epidural scar tissue were calculated. Results:Moderate to marked epidural adhesion was found in HCPT group,no obvious adhesion was formed in MMC group,while severe epidural adhesion formed in control group. SEP has no significant difference before and after administration. The count of fibroblasts and the area of epidural scar in HCPT and MMC group was obviously less than that in control group. Conclusion:Topical and transitory application of MMC and HCPT may be a successful method of preventing postlaminectomy epidural fibrosis.

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孙 钰,曹晓建,汪 雷,孙思鑫.羟基喜树碱和丝裂霉素C预防椎板切除术后硬膜外瘢痕粘连的研究[J].南京医科大学学报(自然科学版),2007,(11):1213-1216

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  • 收稿日期:2007-04-16
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