目的：探讨Ⅰ型胶原-转化生长因子-β1（Transform growth factor，TGF-β1）-纤维蛋白胶复合材料修复兔半月板无血运区损伤的临床效果。方法选取健康新西兰大白兔60只，在半月板损伤造模的基础上随机分为损伤对照组（A 组）、TGF-β1组（B 组）、Ⅰ型胶原-纤维蛋白胶组（C 组）和Ⅰ型胶原-TGF-β1-纤维蛋白胶组（D 组）。A 组不做处理，C 组与 D 组于关节腔内分别一次性注入Ⅰ型胶原-生物蛋白胶复合物、Ⅰ型胶原-TGF-β1-纤维蛋白胶复合材料至填充物与半月板表面相平为止；B 组于关节腔内连续注射3周 TGF-β1。术后2周、4周、12周分批处死动物，进行形态学观察和组织学检查。结果形态学观察发现，损伤后各组新西兰大白兔的半月板组织形态变小，颜色微黄，质地较硬，脆性增加。组织学检查发现，B 组对半月板无血运区损伤的愈合无明显影响，仅对半月板边缘滑膜中的成纤维细胞有明显的促进作用；C 组半月板伤口较术前小，表面稍凹陷，愈合组织与邻近半月板组织结合紧密；D 组半月板表现为纤维软骨样愈合，但愈合部分与正常半月板仍有差异。A 组、B 组、C 组，在4周、12周时与 D 组愈合情况比较差异有统计学意义（P ＜0．05）。结论采用Ⅰ型胶原-TGF-β1-生物蛋白胶复合材料对半月板无血运区损伤治疗是非缝合技术治疗半月板损伤的一种可靠手段。%Objective To explore the type I collagen-transforming growth factor-β1 (Transform growth factor of TGF-β1)-fibrin glue composite repair rabbit meniscus injury effect of avascular zone.Methods Healthy New Zealand white rabbits 60,the first unified damage model avascular zone in rabbits meniscus.Randomly divided into control group,TGF-β1 group,type I collagen-the fibrin glue group,and collagen type I-TGF-β1 in-fiber protein glue group.Con-trol group did not deal with.Type I collagen fibrin glue complex,type-TGF-collagen I beta 1-fibrin glue composite ma-terial one-time injection gap,to the filler and the surface of the meniscus so far;TGF-beta 1 group of joint cavity for three weeks of continuous injection.2 weeks,4 weeks,12 weeks after surgery,respectively,were sacrificed animals, mainly for the observation of gross morphology and histological examination.Results Morphologically,the morphology of the meniscus of New Zealand white rabbits was smaller,and the color of New Zealand white rabbits was slightly yellow,and the texture was hard and brittle.Histological examination,B group of avascular area damage healing without obvious effect,only the synovial membrane at the edge of the meniscus into fiber cells have a significant role in promoting;meniscus wound in group C compared with preoperative small surface is slightly concave,healing tissue and adjacent meniscus tissue closely;group D meniscus showed fibrous cartilage healing,but partially healed with normal meniscus still has the differ-ence.A,B,C group,in 4 weeks,12 weeks,compared with the D group,the difference was statistically significant (P <0.05). Conclusion Collagen type I-TGF-β1 in-fibrin glue composite materials for the treatment of meniscus injury in the non blood circulation area is a reliable treatment method for the treatment of meniscus injury.
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