中国修复重建外科杂志

中国修复重建外科杂志

不同强度跑台训练对大鼠跟腱微损伤修复影响的实验研究

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目的 探讨不同强度跑台训练对胶原酶诱导的大鼠跟腱微损伤修复的影响。 方法 取 8 周龄雄性 SD 大鼠 72 只,体质量 200~250 g,经适应性跑台训练 1 周后,于双侧跟腱各注射 30 μL 浓度为 10 mg/mL 的Ⅰ型胶原酶溶液,制备胶原酶诱导的跟腱微损伤模型。饲养 1 周后随机分为对照组(n=24)、低强度组(n=24)、高强度组(n=24);对照组大鼠可自由活动;低、高强度组采用计算机控制动物实验跑台对大鼠进行被动跑台训练,其中低强度组跑台强度为 13 m/min、20 min/d,高强度组跑台强度为 17 m/min、60 min/d。于训练开始即刻及 1、4 周,每组各取 8 只大鼠双侧跟腱,行大体观察、组织学观察并半定量评分以及生物力学测试。 结果 训练开始即刻,各组跟腱标本大体观察、组织学观察及半定量评分以及生物力学测试比较,差异均无统计学意义(P>0.05),提示各组跟腱微损伤模型损伤程度相似,具有可比性。大体观察示,1 周时,各组腱旁结缔组织增生、肌腱组织缺乏光泽;4 周时,低强度组腱旁增生组织较对照组明显减少,而高强度组腱旁结缔组织较多,并且有大量新生血管形成。组织学观察示,1 周时各组间总分比较差异无统计学意义(P>0.05);低、高强度组仅新生血管量评分与对照组比较,差异有统计学意义(P<0.05)。4 周时,高强度组总分明显高于对照组、低强度组,对照组显著高于低强度组(P<0.05);低强度组纤维排列、细胞形态、细胞异常增多、新生血管量评分与对照组、高强度组比较,高强度组细胞异常增多评分与对照组比较,差异有统计学意义(P<0.05)。生物力学测试示,1 周时各组跟腱横截面积、最终应力、抗拉强度及弹性模量比较,差异均无统计学意义(P>0.05)。4 周时,低强度组最终应力及抗拉强度较对照组明显升高(P<0.05),最终应力及弹性模量较高强度组明显升高(P<0.05);其余各指标组间比较差异均无统计学意义(P>0.05)。 结论 低强度跑台训练能够促进胶原酶诱导的大鼠跟腱微损伤的修复。

Objective To explore the effect of different intensity treadmill training on the repair of micro-injured Achilles tendon induced by collagenase in rats. Methods Seventy-two 8-week-old male Sprague Dawley rats (weighing, 200-250 g) were selected. After adaptive treadmill training for 1 week, rats were injected with 30 μL type I collagenase solution (10 mg/mL) into both Achilles tendons to make micro-injured Achilles tendon models. After 1 week of cage feeding, the rats were randomly divided into 3 groups: the control group, the low-intensity group, and the high-intensity group, 24 rats each group. The rats in control group could move freely, and the rats underwent daily treadmill training at the intensity of 13 m/min and 20 min/d in the low-intensity group and at the intensity of 17 m/min and 60 min/d in the high-intensity group. At immediate, 1 week, and 4 weeks after training, bilateral Achilles tendons were collected from 8 rats of each group for gross observation, histological analysis, and mechanical testing. Results At immediate after training, there was no significant difference in the gross observation, histological observation, and biomechanical properties of the Achilles tendon between groups (P>0.05). The gross observation showed connective tissue hyperplasia near Achilles tendon and lackluster tendon in each group at 1 week; hyperplasia significantly reduced in the low-intensity group when compared with the control group, and there were more connective tissue and a large number of neovascularization in the high-intensity group at 4 weeks. At 1 week, there was no significant difference in the semi-quantitative histological total score between groups (P>0.05), but there were significant differences in vascularity between low-intensity group or high-intensity group and control group (P<0.05). At 4 weeks, the semi-quantitative histological total score was significantly higher in high-intensity group than control group and low-intensity group (P<0.05), and in control group than low-intensity group (P<0.05). There were significant differences in collagen arrangement, cell morphology, abnormal cells, and vascularity between low-intensity group and high-intensity group or control group (P<0.05). And there was significant difference in abnormal cells between high-intensity group and control group (P<0.05). The mechanical testing showed that there was no significant difference in cross-sectional area of the Achilles tendon, the ultimate force, tensile strength, and elastic modulus between groups at 1 week (P>0.05); the low-intensity group was significantly higher than the control group in the ultimate force and the tensile strength (P<0.05), and than high-intensity group in the ultimate force and elastic modulus (P<0.05), but no significant difference was found in the other indexes between groups (P>0.05) at 4 weeks. Conclusion Low-intensity treadmill training can promote the repair of rat micro-injured Achilles tendon induced by collagenase.

关键词: 肌腱病; 肌腱微损伤; 跑台训练; 跟腱; 大鼠

Key words: Tendinopathy; tendon micro-injury; treadmill training; Achilles tendon; rat

引用本文: 高尚, 唐康来, 张吉强, 李跑, 杨志金, 崔海峰, 杨明宇, 唐红, 周梅. 不同强度跑台训练对大鼠跟腱微损伤修复影响的实验研究. 中国修复重建外科杂志, 2017, 31(5): 574-581. doi: 10.7507/1002-1892.201611054 复制

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