同种异体神经移植的影响因素
作者：顾玉荣 蒋电明
单位：重庆医科大学附属第一医院骨科，重庆400042
关键词：周围神经：异体移植；影响因素
创伤外科杂志000331摘 要：异体神经修复神经缺损易被排异。人们采用了一些预处理方法，如冷冻、放疗等来降低异体神经移植体的抗原性，虽然取得了一些进展，但结果仍不满意。应用免疫抑制剂，效果较理想，但停药后排异反应仍难避免。神经移植体的血供及手术吻合方式对神经再生也有影响。总之，周围神经同种异体移植的关键是免疫排斥，这一方面的研究仍处于实验阶段。
分类号：R651.3 文献标识码：A
文章编号：1009-4237(2000)03-0186-03
The effecting factor of peripheral nerve allograft
, http://www.100md.com
GU Yu-rong,JIANG Dian-min
(Departmet of Orthopaedics, The First Hospital Affiliated to Chongqing Medical College, Chongqing, 400016)
Abstract：Nerve allografts used for treating nerve defects are susceptible to rejection. Some pretreatment methods, Such as freeze - thawing and radiotherapy, have been used for decreasing nerve allograft antigenicity. Although some progress has been made, the results are still unsatisfactory. Immunosuppressant may provide results comparable to nerve autografts. However, immune response will recur after immunosupressant is withdrawn. The kind of anastomosis and blood supply of nerve allograft also effect nerve regeneration. In conclusion, the most important problem of paripheral nerve allograft is immunoreactivity. The use of transplanted nerve allografts remains experimental.
, 百拇医药
Keywords：peripheral nerve; allograft; effecting factor
参考文献：
[1]Staniforth P. The effects of sural nerve grafting[J]. The Hand, 1978,10:187-188.
[2]George Bonny MS. Experience with vascularized nervegrafts[J]. Clin Plast Surg, 1984, 11:137-139.
[3]Fawcett JW, Keynes RJ. Muscle basal lamine: a new graft material for peripheral nerve repair[J]. J Neurosurg, 1986,65:354-357.
, http://www.100md.com
[4]Mackinnon SE. Surgical management of peripheral nerve gap[J]. Clin Plast Surg, 1989,16:587-590.
[5]Chiu DTW. Autogenous vein grafty conduit for nerve regeneration[J]. Surgery, 1982,91:226-228.
[6]Classby MA. Regeneration of the sciatic nerve in rats. The effect of muscle basement membrane[J]. J Bone Joint Surg (Br), 1986,68:829-831.
[7]孔吉明.用骨胳肌引导再生实验模型的制备和应用[J].临床解剖学杂志，1987，5：17-19.
, 百拇医药
[8]王铁霞，徐锡萍，曾志城，等.同系异体神经桥接大鼠周围神经缺损的形态学观察[J].湖南医科大学学报，1994，19(6)；541-544.
[9]李中玉.周围神经同种异体移植进 展[J].国外医学·创伤与外科基本问题分册，1990，3：135-136.
[10]宋修竹，贺长清，顾玉东.酒精处理的同种异体周围神经移植的研究.中华实验外科杂志，1998，15(3)：263-264.
[11]Mackinnon SE. Neurosurgery[M], 1984,14(2): 167-171.
[12]Fansa H, keilhoff G, Altmann S, et al. The effect of the immunosuppressant FK 506 on peripheral nerve regeneration following nerve grafting[J]. J Hand Surg (Br), 1999,24(1):38-42.
, http://www.100md.com
[13]Midha R, Munro CA, Mackinnon SE. Motor and sensory specificity of host nerve axons influence nerve allograft rejection[J]. J Neuropathol Exp Neurol, 1997,56(4):421-434.
[14]Takata H, Ishiada O, Ochi M, et al. Rejection and regeneratioa in peripheral nerve homografts in rats after withdrawal of cyclosporin: morphological and immunohistochemical assessment[J]. Scand J Plast Reconstr Surg, 1999,33(4):373-377.
[15]Grochowica P. Transplantation Prol[M], 1989. 21(1):3181-3183.
, http://www.100md.com
[16]Stancic MF, Potocnjak M, Micovic V, et al. Evaluation of function nerve graft treated with ICAM-1 and LFA-1 mAbs can be alternative to syngeneic graft[J]. Acta Neurochir(Wien), 1999,141(8):875-879.
[17]Ochi M, Adachi N, Dohi D, et al. Improvement in nerve regeneration by monoclonal antibodies o ICAM-1 and and LFA-1 in allogeneic nerve[J]. Scand J Plast Reconstr Surg Hand Surg, 1998,32(4):373-380.
[18]Tajima K,Tohama K, Ide C, et al. Regeneration through nerve allografts in the cynornolgns mondey (macaca fascicularis)[J]. J Bone Joint Surg(Am), 1991,93:172-176.
, http://www.100md.com
[19]Osawa T, Ide C, Tohgama K, et al. Nerve regeneration through cryo-treated allogevneic nervegrafts[J]. Arch Histol Jpn, 1987,50:193-195.
[20]Tohyama K, Ide C. Nerve regeneration through the cryojurned allogeneic nerve graft in the rabbit[J]. Acta Neuro Pathol Berl, 1990,80:138-141.
[21]Gulatic AK, Cole GP. Nerve graft immunogenicity as a factor determining axonal regeneration in the rat[J]. J Neurosurg, 1990,71:114-118.
, 百拇医药
[22]高永华.液态氮冷冻保存对异体神经移植的影响[J].中华显微外科杂志，1989，12：101-102.
[23]Evans PJ, Mackinnon SE, Midha R, et al. Regeneration across cold preserved peripheral nerve allograft[J]. Microsurgery, 1999, 19(3):115-127.
[24]Tian L, Zhan J, Wang S. Chung Kuo Hsiu Fu Chung Chien Wai Ko Tsa Chih, 1998,12(3):138-140.
[25]王秋根，应明，鲁树荣，等.同种异体神经移植后免疫反应的实验研究[J].上海医学，1998，21(1)：14-16.
[26]Evans PJ, Mackinnon SE, Levi AD, et al. Cold preserved allografts: changes in basement membrane, viability, immunogenicity and regeneration[J]. Muscle Nerve, 1998,21(11): 1501-1522.
, http://www.100md.com
[27]郑桂芬，辛畅泰，安贵林，等.受体血浆冷冻异体神经桥接神经缺损的形态学研究[J].中华手外科杂志，2000，16(2)：123-125.
[28]Sondell M, Lundborg G, Kanje M. Regeneration of the rat sciatic nerve into allografts made acellular through chemical extraction[J]. Brain Res, 1998,795:44-54.
[29]Dumont CE, Hentz VR. Enhancement of axon growth by detergent extracted nerve grafts[J]. Transplantation, 1997,63(9):1210-1215.
[30]刘强，孟庆水，韩西城，等.胎兔周围神经同种异体移植的实验研究[J].中华手外科杂志，1996，12(2)：113-115.
收稿日期：2000-05-26
修稿日期：2000-07-12, http://www.100md.com
单位：重庆医科大学附属第一医院骨科，重庆400042
关键词：周围神经：异体移植；影响因素
创伤外科杂志000331摘 要：异体神经修复神经缺损易被排异。人们采用了一些预处理方法，如冷冻、放疗等来降低异体神经移植体的抗原性，虽然取得了一些进展，但结果仍不满意。应用免疫抑制剂，效果较理想，但停药后排异反应仍难避免。神经移植体的血供及手术吻合方式对神经再生也有影响。总之，周围神经同种异体移植的关键是免疫排斥，这一方面的研究仍处于实验阶段。
分类号：R651.3 文献标识码：A
文章编号：1009-4237(2000)03-0186-03
The effecting factor of peripheral nerve allograft
, http://www.100md.com
GU Yu-rong,JIANG Dian-min
(Departmet of Orthopaedics, The First Hospital Affiliated to Chongqing Medical College, Chongqing, 400016)
Abstract：Nerve allografts used for treating nerve defects are susceptible to rejection. Some pretreatment methods, Such as freeze - thawing and radiotherapy, have been used for decreasing nerve allograft antigenicity. Although some progress has been made, the results are still unsatisfactory. Immunosuppressant may provide results comparable to nerve autografts. However, immune response will recur after immunosupressant is withdrawn. The kind of anastomosis and blood supply of nerve allograft also effect nerve regeneration. In conclusion, the most important problem of paripheral nerve allograft is immunoreactivity. The use of transplanted nerve allografts remains experimental.
, 百拇医药
Keywords：peripheral nerve; allograft; effecting factor
参考文献：
[1]Staniforth P. The effects of sural nerve grafting[J]. The Hand, 1978,10:187-188.
[2]George Bonny MS. Experience with vascularized nervegrafts[J]. Clin Plast Surg, 1984, 11:137-139.
[3]Fawcett JW, Keynes RJ. Muscle basal lamine: a new graft material for peripheral nerve repair[J]. J Neurosurg, 1986,65:354-357.
, http://www.100md.com
[4]Mackinnon SE. Surgical management of peripheral nerve gap[J]. Clin Plast Surg, 1989,16:587-590.
[5]Chiu DTW. Autogenous vein grafty conduit for nerve regeneration[J]. Surgery, 1982,91:226-228.
[6]Classby MA. Regeneration of the sciatic nerve in rats. The effect of muscle basement membrane[J]. J Bone Joint Surg (Br), 1986,68:829-831.
[7]孔吉明.用骨胳肌引导再生实验模型的制备和应用[J].临床解剖学杂志，1987，5：17-19.
, 百拇医药
[8]王铁霞，徐锡萍，曾志城，等.同系异体神经桥接大鼠周围神经缺损的形态学观察[J].湖南医科大学学报，1994，19(6)；541-544.
[9]李中玉.周围神经同种异体移植进 展[J].国外医学·创伤与外科基本问题分册，1990，3：135-136.
[10]宋修竹，贺长清，顾玉东.酒精处理的同种异体周围神经移植的研究.中华实验外科杂志，1998，15(3)：263-264.
[11]Mackinnon SE. Neurosurgery[M], 1984,14(2): 167-171.
[12]Fansa H, keilhoff G, Altmann S, et al. The effect of the immunosuppressant FK 506 on peripheral nerve regeneration following nerve grafting[J]. J Hand Surg (Br), 1999,24(1):38-42.
, http://www.100md.com
[13]Midha R, Munro CA, Mackinnon SE. Motor and sensory specificity of host nerve axons influence nerve allograft rejection[J]. J Neuropathol Exp Neurol, 1997,56(4):421-434.
[14]Takata H, Ishiada O, Ochi M, et al. Rejection and regeneratioa in peripheral nerve homografts in rats after withdrawal of cyclosporin: morphological and immunohistochemical assessment[J]. Scand J Plast Reconstr Surg, 1999,33(4):373-377.
[15]Grochowica P. Transplantation Prol[M], 1989. 21(1):3181-3183.
, http://www.100md.com
[16]Stancic MF, Potocnjak M, Micovic V, et al. Evaluation of function nerve graft treated with ICAM-1 and LFA-1 mAbs can be alternative to syngeneic graft[J]. Acta Neurochir(Wien), 1999,141(8):875-879.
[17]Ochi M, Adachi N, Dohi D, et al. Improvement in nerve regeneration by monoclonal antibodies o ICAM-1 and and LFA-1 in allogeneic nerve[J]. Scand J Plast Reconstr Surg Hand Surg, 1998,32(4):373-380.
[18]Tajima K,Tohama K, Ide C, et al. Regeneration through nerve allografts in the cynornolgns mondey (macaca fascicularis)[J]. J Bone Joint Surg(Am), 1991,93:172-176.
, http://www.100md.com
[19]Osawa T, Ide C, Tohgama K, et al. Nerve regeneration through cryo-treated allogevneic nervegrafts[J]. Arch Histol Jpn, 1987,50:193-195.
[20]Tohyama K, Ide C. Nerve regeneration through the cryojurned allogeneic nerve graft in the rabbit[J]. Acta Neuro Pathol Berl, 1990,80:138-141.
[21]Gulatic AK, Cole GP. Nerve graft immunogenicity as a factor determining axonal regeneration in the rat[J]. J Neurosurg, 1990,71:114-118.
, 百拇医药
[22]高永华.液态氮冷冻保存对异体神经移植的影响[J].中华显微外科杂志，1989，12：101-102.
[23]Evans PJ, Mackinnon SE, Midha R, et al. Regeneration across cold preserved peripheral nerve allograft[J]. Microsurgery, 1999, 19(3):115-127.
[24]Tian L, Zhan J, Wang S. Chung Kuo Hsiu Fu Chung Chien Wai Ko Tsa Chih, 1998,12(3):138-140.
[25]王秋根，应明，鲁树荣，等.同种异体神经移植后免疫反应的实验研究[J].上海医学，1998，21(1)：14-16.
[26]Evans PJ, Mackinnon SE, Levi AD, et al. Cold preserved allografts: changes in basement membrane, viability, immunogenicity and regeneration[J]. Muscle Nerve, 1998,21(11): 1501-1522.
, http://www.100md.com
[27]郑桂芬，辛畅泰，安贵林，等.受体血浆冷冻异体神经桥接神经缺损的形态学研究[J].中华手外科杂志，2000，16(2)：123-125.
[28]Sondell M, Lundborg G, Kanje M. Regeneration of the rat sciatic nerve into allografts made acellular through chemical extraction[J]. Brain Res, 1998,795:44-54.
[29]Dumont CE, Hentz VR. Enhancement of axon growth by detergent extracted nerve grafts[J]. Transplantation, 1997,63(9):1210-1215.
[30]刘强，孟庆水，韩西城，等.胎兔周围神经同种异体移植的实验研究[J].中华手外科杂志，1996，12(2)：113-115.
收稿日期：2000-05-26
修稿日期：2000-07-12, http://www.100md.com