下颌牵张成骨中应用神经生长因子对神经损伤修复作用.docVIP

下颌牵张成骨中应用神经生长因子对神经损伤修复作用 　作者：杜兆杰，雷德林，王磊，曹健，张雅博，张圃，马秦，程晓兵 【摘要】 目的 研究下颌骨牵张成骨中全身注射神经生长因子(NGF)对损伤的下齿槽神经的修复作用。方法 新西兰白兔48只，全麻下行双侧下颌骨牵张成骨术，术后第4天以 0.5mm/12h的速度牵张，共10天。术后即分别给予肌注NGF 0.6μg/d×20天和相当量生理盐水。采用BL420F生物机能实验系统及检测设备，分别在术前、牵张期结束、固定期1、2、4周时行感觉神经动作电位(SNAP)测试。结果 在牵张完成时、固定期1周，NGF组和对照组的SNAP波幅和潜伏期无统计学差异;在固定期2、4周，NGF组波幅明显高于对照组，而潜伏期明显低于对照组(Plt;0.05)。结论 全身注射NGF有利于牵张成骨中下齿槽神经功能的恢复。 【关键词】 神经生长因子;牵张成骨; 感觉神经动作电位;下齿槽神经 Recovery effect of systemic injection of nerve growth factor on inferior alveolar nervein a rabbit model of mandibular distraction osteogenesis 　　Abstract： Objective To study the recovery effect of the inferior alveolar nerve following systemic injection of NGF (nerve growth factor) in a rabbit model of mandibular distraction osteogenesis.Methods Totally 48 New Zealand white rabbits underwent bilateral distraction osteogenesis with a rate of 0.5mm/12h for 10 days.Immediately after surgery,0.6μg/d×20d NGF or normal saline were intramuscularly injected respectively.BL420F monitoring system was applied to record the sensory nerve action potentials(SNAP) before surgery,at the end of distraction,or at consolidation time of 1,2,4 weeks respectively.Results At the end of distraction and 1 week following distraction,the amplitude of the evoked potentials and latency showed no statistical difference between the NGF group and control group;at the consolidation time of 2,4 weeks,the amplitude of the evoked potentials and latency was significantly higher and lower respectively in NGF group than that in control group(Plt;0.05).Conclusion Systematic injection of NGF can help to accelerate the function recovery of inferior alveolar nerve in mandibular distraction osteogenesis. 　　Key words：nerve growth factor;distraction osteogenesis;sensory nerve action potential;inferior alveolar nerve 　　牵张成骨技术(distraction osteogenesis,DO)又称为“自体性骨组织工程”，是20世纪50 年代由前苏联学者Ilizarov[1]发展和完善并用于矫治各类四肢长骨畸形的一种方法，90年代后开始应用于口腔颌面外科域[2]，且发展迅速，已成为这一领域的研究热点之一。下颌骨有特殊的解剖结构：下齿槽神经(inferior alveolar nerve，IAN)位于骨性下颌管