BACKGROUND: Injured nerve can regenerate through end-to-side anastomosis and obtain partial physiological function in animal experiment. As an immuno-suppressivedrug, FK506, which is characterized by promoting neural growth and functional recovery, is paid widely attention to.OBJECTIVE: To investigate the effect of FK506 on functional recovery of peripheral nerve after end-to-side anastomosis.DESIGN: Randomized controlled animal study.SETTING: Department of Operation Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was completed in the Department of Operation Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology in March 2005. Totally 26female Wistar rats were selected and divided into experimental group and control group with 13 in each group.METHODS: Peroneal nerve was transacted on the right side of all the animals, the proximal end of peronieal nerve was turned back and ligated, and the distal end was sutured to the side of tibial nerve with perineurial window. No operation was done on the left side. FK506 was injected in the right tibial muscle (2 mg/kg· d), once a day within two weeks in the experimental group, and saline was used in another group as contrast.MAIN OUTCOME MEASURES: Three months afteroperation, the bilateral common peroneal nerve and the tibial muscle were taken for electrophysiological and histological examination, and the number of common peroneal nerve fiber, area of tibialis anterior muscle fiber of transverse section and muscle wet weight of tibialis anterior muscle were measured. The results were expressed with the ratio between right side and left side (i.e.recovery rate).RESULTS: Totally 26 rats entered the final analysis. ① Results of histological examination: Both ratio of number of nerve fiber and ratio of area of muscle fiber in the experimental group were higher than those in the control group (0.734±0.143, 0.412±0.119; 0.628±0.125, 0.432±0.135; P ＜ 0.01,0.05). ② Results of electrophysiological examination: Recovery rate of action potential, recovery rate of single muscular contractility and recovery rate of tetanus contractility in the experimental group were higher that those in the control group (P ＜ 0.05). ③ Ratio of wet weight in the experimental group was higher than that in the control group (0.765±0.101,0.513±0.116, P ＜ 0.05).CONCLUSION: FK506 injected into targeted muscle can promote growth and functional recovery of peripheral nerve in end-to-side anastomosis.%背景:通过动物实验发现损伤的神经可以通过端侧吻合再生并获得部分生理功能.FK506作为免疫抑制剂具有的促进神经生长及功能恢复的作用已引起了广泛关注.目的:观察FK506对神经端侧吻合功能恢复的影响.设计:随机对照动物实验.单位:华中科技大学同济医学院附属协和医院手外科.材料:实验于2005-03在华中科技大学同济医学院附属协和医院手外科实验室进行.取Wistar雌性大白鼠26只,随机分为实验组和对照组,每组13只.方法:所有动物右侧腓总神经切断后,近端反转结扎,远端与胫神经外膜开窗处行端侧吻合,左侧作正常对照.于术后当天开始,实验组右小腿外侧肌肉注射生理盐水稀释的FK506[2 mg/(kg·d)],连续2周,对照组注射等量的生理盐水.主要观察指标:术后3个月,行双侧腓总神经、胫前肌电生理及组织学检查,测定腓总神经纤维数目、胫前肌肌纤维横切面积,同时测定胫前肌肌湿重.结果用右侧测得值与左侧的比值(即恢复率)来表示.结果:26只大鼠全部进入结果分析.①组织学检查结果:实验组神经纤维数目比和肌纤维截面积比均高于对照组(0.734±0.143,0.412±0.119;0.628±0.125,0.432±0.135;P＜0.01,0.05).②电生理检测结果:实验组动作电位恢复率、肌肉单次收缩力恢复率、强直收缩力恢复率均显著高于对照组(P＜0.05).③实验组肌湿重比也高于对照组(0.765±0.101,0.513±0.116,P＜0.05).结论:靶肌肉注射FK506能促进周围神经端侧吻合侧支生长及功能恢复.
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