兔前交叉韧带损伤后膝关节本体感觉、残端血运及膝关节腔尿激酶型纤溶酶原激活物变化的实验研究

摘要 目的：研究兔前交叉韧带（ACL）损伤后膝关节本体感觉、残端血运及膝关节腔尿激酶型纤溶酶原激活物（u-PA）的变化情况。方法：选取80只新西兰兔进行研究，将其以随机数字表法分作模型组及空白对照组各40只。模型组建立单侧ACL损伤模型，空白对照组仅切开关节。比较两组术前及术后2周、4周、8周时膝关节本体感觉、残端血运及膝关节腔u-PA水平的差异。结果：模型组新西兰兔术后2周、4周、8周时的体感诱发电位（SEP）、肌电图（EMG）潜伏期均高于空白对照组，而SEP、EMG波幅均低于空白对照组（P＜0.05）。模型组新西兰兔术后2周、4周、8周时的残端组织微血管密度分别为（2.04±0.24）n/mm²、（2.75±0.61）n/mm²、（1.60±0.33）n/mm²，均高于空白对照组的（1.34±0.24）n/mm²、（1.34±0.25）n/mm²、（1.35±0.26）n/mm²，差异均有统计学意义（P＜0.05）。模型组新西兰兔术后2周、4周、8周时的膝关节液u-PA水平分别为（173.97±14.29）pg/mL、（188.37±15.82）pg/mL、（171.38±14.76）pg/mL，均高于空白对照组的（158.02±10.18）pg/mL、（157.68±10.20）pg/mL、（157.37±10.07）pg/mL，差异均有统计学意义（P＜0.05）。结论：ACL损伤后会在不同程度上影响膝关节本体感觉、残端血运及膝关节腔u-PA含量，值得临床进一步研究。

Experimental Study on Changes of Knee Proprioception, Stump Blood Supply and Urokinase-Type Plasminogen Activator in the Knee Cavity after Anterior Cruciate Ligament Injury in Rabbit

ABSTRACT Objective: To study the changes of knee proprioception, stump blood supply and urokinase-type plasminogen activator (u-PA) in the knee cavity after anterior cruciate ligament (ACL) injury in rabbits. Methods: 80 New Zealand rabbits were selected for the study, and they were divided into model group and blank control group with 40 rabbits each by random number table method. A unilateral ACL injury model was established in the model group, and only the joint was cut open in the blank control group. The knee proprioception, stump blood supply and u-PA level in the knee cavity were compared between the two groups before and 2, 4 and 8 weeks after operation. Results: The incubation period of somatosensory evoked potential (SEP) and electromyography (EMG) in the model group were higher than those in the blank control group at 2, 4 and 8 weeks after operation, while the amplitude of SEP and EMG were lower than those in the blank control group (P<0.05). The microvessel density of stump tissue in the model group at 2, 4 and 8 weeks after operation were (2.04±0.24) n/mm², (2.75±0.61) n/mm² and (1.60±0.33) n/mm² respectively, which were higher than those in the blank control group (1.34±0.24) n/mm², (1.34±0.25) n/mm², (1.35±0.26) n/mm², the differences were statistically significant (P<0.05). The u-PA level of articular fluid in the model group at 2, 4 and 8 weeks after operation were (173.97±14.29) pg/mL, (188.37±15.82) pg/mL, (168.38±14.76) pg/mL respectively, which were higher than those in blank control group (158.02±10.18) pg/mL, (157.68±10.20) pg/mL, (157.37±10.07) pg/mL, the differences were statistically significant (P<0.05). Conclusion: After ACL injury, the knee proprioception, stump blood supply and u-PA content in the knee cavity can be affected to different degrees, which is worthy of further clinical study.