摘要
学术背景:肌腱损伤后传统的手术治疗虽然可以减轻患者的痛苦,但其功能重建结果往往不令人乐观。随着组织工程化肌腱的发展,利用组织工程技术修复肌腱缺损已成为一种新的治疗手段。目的:对种子细胞、支架材料、工程化肌腱的构建以及动物实验的方法和检测等研究进展进行综述。检索策略:由作者应用计算机检索Medline,EBSCO以及google scholar引擎中1990-02/2007-05关于组织工程化肌腱的文献,检索词"tissue engineering,engineered tissue,tissue-engineered tendon,scaffold,implantation in vivo,seed cells",检索词被分别组合进行检索,限定文献语言种类为"English"。同时计算机检索维普数据库1990-02/2007-05关于细胞和支架材料的文献,检索词"组织工程,工程化组织,种子细胞,支架,体内植入,组织工程化肌腱",限定文献语言种类为中文。纳入标准:重点选取与构建组织工程化肌腱以及体内植入修复肌腱缺损相关的基础与临床研究。排除标准:关于配子、胚胎和组织工程化骨、血管等的文章。文献评价:①文献来源有RCT,循证医学系统综述、汇总分析、个例报道、经验交流。②共检索到214篇关于细胞和支架材料以及体内植入的文献,其中与本实验关系密切的文献14篇,间接相关45篇,最终纳入35篇符合标准的文献。资料综合:目前运用于组织工程化肌腱的种子细胞主要有间充质干细胞、胚胎干细胞和成纤维细胞,多用聚乳酸、聚羟基乙酸及二者的共聚物作为支架材料。在复合物的培养方面,提出细胞-支架材料复合物体外构建过程中引入动态的机械力牵拉,可使修复后的肌腱具有更好的生物力学强度。组织工程肌腱植入体内后的检测方法除大体观察和组织学检测外,其力学性能检测也是必要的,且分子生物学检测技术也越来越多的应用于研究中。结论:组织工程化肌腱可以成为一种较好修复临床肌腱损伤的方法,但需要探索最适的种子细胞、支架材料、培养条件以及植入体内后的检测方法。
BACKGROUND： Although the traditional operative therapy for tendon defect could relieve the suffering of patients, the functional reconstruction was usually not optimistic. With the development of tissue-engineering tendon, using engineered tendon to repair tendon defect was becoming a new therapeutic method. OBJECTIVE： To summanze the advances of seed cells, scaffolds, and the ways to construct tissue-engineered tendon, implantation in vivo and detection. RETRIEVE STRATEGY： A computer-based online search of Medline, EBSCO and google scholar based search was undertaken to identify the articles on tissue-engineered tendon published in English from February 1990 to May 2007 with the key words of ＂ tissue engineering,engineered tissue,tissue-engineered tendon,scaffold,implantation in vivo, seed cells＂. Meanwhile, VIP Database was searched for the related articles published in Chinese from February 1990 to May 2007 with the key words of ＂tissue engineering, engineered tissue, seed cell, scaffold, implantation in vivo, tissue-engineered tendon＂ in Chinese. Inclusive criteria included that the study should be basic and/or clinical research on constructing engineered tendon and implantation in vivo. Exclusive criteria included articles about the gamete, embryo, tissue-engineered bone and tissue-engineered blood vessel. LITERATURE EVALUATION： ①The source of literatures contained RCT, the systematic review of evidence-based medicine, meta-analysis, case of a particular disease and symposium. ②Totally 214 articles about seed cells, scaffolds and the methods to construct engineered tendon were found in these database, among which 14 were closely associated with the study and 45 were indirectly related. Finally, 35 articles met with inclusive criteria were selected. DATA SYNTHESIS： At present seed cells used in tissue-engineered tendon include rnesenchymal stem cells, embryonic stem cells and fibroblasts. Polylactic acid and polyglycolic acid and their copolymer are utilized as scaffolds. Dynamic mechanical drag in construction of cell-scaffold compound in vitro can make tendon have better biodynamic intensity after repair. Except general observation and histological detection, mechanic performance determination is also necessary after implantation of tissue-engineered tendon. Besides, molecular biology technology is also widely applied in the research. CONCLUSION： Tissue-engineered tendon may become a new method to repair tendon defect. However, it is necessary to find the suitable seed cells, scaffolds, culture conditions and detection methods after implantation in vivo.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第40期8136-8139,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
国家自然科学基金资助项目(30570469)~~
作者简介
刘程俊．男．1982年生，四川省成都市人，汉族．四川大学在读硕士、主要从事骨组织工程与生物力学的研究。yooseungiun1982@126.com
通讯作者：秦廷武，博士后，博士生导师．教授．四川大学华西医院生物治疗国家重点实验室干细胞与组织工程研究室．四川省成都市610041 qtw@mcwcums.com
