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目的 :探讨尿激酶型纤溶酶原激活剂 (uPA)在神经再生微环境中的作用机制 ,观察uPA对面神经断伤吻合后神经再生修复的影响。方法 :将 2 4只SD大鼠随机分为uPA组和对照组 ,建立大鼠面神经断伤修复模型 ,uPA组术后连续 5d腹部皮下注射uPA ,每天 3次 ,每次 5 0 0 0U/kg ,对照组注射等体积生理盐水。术后 1,7,14 ,2 1,4 2 ,84d取吻合处远侧段面神经 ,采用形态学、免疫组织化学和图像分析技术 ,观察分析两组中神经纤维的等效直径、周长和面积参数以及纤维连结蛋白 (fibronectin ,FN)和层粘连蛋白 (laminin ,LN)伤后早期的表达变化。结果 :术后 2 1,4 2d时uPA组新生神经纤维髓鞘面积和 4 2d时等效直径均较对照组恢复好 (P <0 .0 5 )。FN在术后表达逐渐增强 ,14 ,2 1d时较对照组明显增多 (P <0 .0 5 )。两组中LN术后表达均减少 ,随再生过程而逐渐增多 ,组间差别无统计学意义。结论 :面神经断伤吻合后应用uPA可降解纤维蛋白 ,使FN表达上调 ,有利于改善神经再生后的微环境 ,提高新生神经纤维的再生修复效果
Objective: To investigate the mechanism of urokinase-type plasminogen activator (uPA) in nerve regeneration microenvironment, and to observe the effect of uPA on nerve regeneration and repair after anastomosis of facial nerve. Methods: Twenty-four SD rats were randomly divided into uPA group and control group, and the model of facial nerve repair was established. The uPA group received subcutaneous injections of uPA subcutaneously 5 days per day for 3 times a day for 5 000 U / kg The control group was injected with equal volume of normal saline. At 1, 7, 14, 2, 14, 2, and 84 days after operation, the distal part of the anastomosis was removed. The morphological, immunohistochemical and image analysis techniques were used to observe the changes of the equivalent diameter, Area parameters and early changes of fibronectin (FN) and laminin (LN) after injury. Results: In the twelfth day and the second day after operation, the newborn nerve fibers in uPA group and the equivalent diameter at 42 days were better than the control group (P <0.05). The expression of FN gradually increased after operation, and was significantly increased at 14 and 21 days (P <0.05). LN expression in both groups decreased, with the regeneration process gradually increased, the difference between the groups was not statistically significant. CONCLUSION: The application of uPA degrades fibrin after anastomosis of facial nerve and up-regulates the expression of FN, which is beneficial to improve the microenvironment after nerve regeneration and improve the regeneration and repair effect of nasal nerve fiber