CAJ | 학술논문

目的比较颈胸椎前路和后路臂丛神经下干切断伤与根性撕脱伤诱发神经病理性疼痛大鼠术侧后足的痛行为学特征.方法 18只成年雌性SD大鼠随机接受右侧前路下干切断、前路及后路下干根性撕脱手术(每组6只),另外6只健康大鼠作为对照组.臂丛损伤术前及术后3、7、14和28 d,检测大鼠术侧后足的机械痛缩足阈值、冷刺激诱发痛评分及热刺激缩足潜伏期.结果对照组与3个损伤组之间术前三项痛行为学指标的差异无统计学意义.与术前相比,前路切断伤组冷刺激诱发痛评分明显增高(P<0.01),机械痛缩足阈值及热刺激缩足潜伏期则无明显变化;前路及后路撕脱伤组术后各时间点机械痛缩足阈值均显著降低(P<0.01),冷刺激诱发痛评分均明显增高(P<0.01),而热刺激缩足潜伏期则无显著变化.与切断伤组相比,两撕脱伤组术后各时间点热刺激缩足潜伏期则无显著差异,而后足机械痛缩足阈值均显著降低(P<0.05),冷刺激诱发痛评分亦显著增高(P<0.01),这种痛行为学的变化可持续至28 d(最长观察期);两撕脱伤组间各痛行为学指标的差异无统计学意义.结论大鼠前、后入路臂丛下干根性撕脱伤均可作为理想的神经病理性疼痛模型,而臂丛下干切断伤因致痛效果较差则不宜用作神经病理性痛模型.
목적 비교경흉추전로화후로비총신경하간절단상여근성시탈상유발신경병이성동통대서술측후족적통행위학특정.방법 18지성년자성SD대서수궤접수우측전로하간절단、전로급후로하간근성시탈수술(매조6지),령외6지건강대서작위대조조.비총손상술전급술후3、7、14화28 d,검측대서술측후족적궤계통축족역치、랭자격유발통평분급열자격축족잠복기.결과 대조조여3개손상조지간술전삼항통행위학지표적차이무통계학의의.여술전상비,전로절단상조랭자격유발통평분명현증고(P<0.01),궤계통축족역치급열자격축족잠복기칙무명현변화;전로급후로시탈상조술후각시간점궤계통축족역치균현저강저(P<0.01),랭자격유발통평분균명현증고(P<0.01),이열자격축족잠복기칙무현저변화.여절단상조상비,량시탈상조술후각시간점열자격축족잠복기칙무현저차이,이후족궤계통축족역치균현저강저(P<0.05),랭자격유발통평분역현저증고(P<0.01),저충통행위학적변화가지속지28 d(최장관찰기);량시탈상조간각통행위학지표적차이무통계학의의.결론 대서전、후입로비총하간근성시탈상균가작위이상적신경병이성동통모형,이비총하간절단상인치통효과교차칙불의용작신경병이성통모형.
Objective To compare the neuropathic pain behaviors of the rat ipsilateral foot after transection or root avulsion of the right lower trunk of brachial plexus via anterior Or posterior approaches.Methods Eighteen adult female Sprague-Dawley rats were randomly divided into three groups with 6 each,in which the animals received transection of the right lower trunk via anterior approach,root avulsion via anterior approach,and root avulsion via posterior approach,respectively.Another 6 animals without any plexus injury were used as the normal control.Mechanical withdrawal threshold(MWT),cold allodynia scores(CAS) and thermal withdrawal latency(TWL) of the ipsilateral hindpaws Were evaluated before and 3,7,14 and 28 days after the surgery. Results No significant difference in the pain parameters was detected among the control and experimental animals in the 3 plexus injury groups preoperatively.In comparison of the parameters before the surgery,CAS increased markedly(P<0.01) but MWT and TWL remained unchanged in the anterior transection group;MWT significantly declined(P<0.01)and CAS elevated(P<0.01)at all postoperative time points but no changes in TWL were observed in both anterior and posterior avulsion groups.Comparing with the transection group,MWT significantly decreased(P<0.05)and CAS increased markedly(P<0.01)while TWL remained unchanged after surgery in both avulsion groups.These behavioral changes remained for 28 days,the longest observation period.No difference could be found between the two avulsion groups. Conclusion Lower trunk avulsion of the brachial plexus via both anterior and posterior approaches can be used as an ideal model to induce neuropathic pain,while lower trunk transection can hardly be a pain model as it induces no classic neuropathic pain.