目的 探讨腹腔联合应用鼠源性神经生长因子(NGF)及三磷酸腺苷(ATP)对周围神经损伤修复及失神经肌肉的作用. 方法 选取SD大白鼠96只,体重(250±15)g,雌雄不限,按随机数字表法分为等渗盐水组(NS组)、ATP组、NGF组、ATP+NGF组;选取大鼠坐骨神经,暴露后人为切断造成3 mm缺损损伤,通过硅胶管连接两神经断端,建立神经再生室.术后立即对各组分别予以腹腔内注射等渗盐水0.4 ml、ATP0.4 ml(1 mg/ml)、NGF0.4 ml(0.2 μg/ml)、NGF+ATP 0.4 ml(ATP 1 mg/ml、NGF 0.2 μg/ml),之后每3 d通过腹腔注射1次.在第2,4,6,8周各组分别取6只大门鼠行坐骨神经指数测定、大体观察、坐骨神经肌电图检查,处死大鼠后切取标本观察再生室区段神经再生状况、腓肠肌湿重,HE染色观察腓肠肌纤维直径及截面积. 结果 术后第2,4,6,8周各组分别取6只大白鼠测定实验数据,NGF+ATP组坐骨神经指数、神经传导速度、腓肠肌湿重优于NS组及单纯ATP或NGF组(P＜0.05).大体观察可见NGF+ATP组患侧足趾红肿程度较其余三组轻,局部溃烂亦相对少,未见足趾脱落者.术后2周,各组神经再生室内可见纤细神经纤维生长,但未将神经断端连接一起.术后4,6,8周,神经再生室内可见神经纤维通过,NGF+ATP组相对其余三组神经纤维生长生长情况较好,且局部炎性反应及纤维粘连轻.NGF组神经纤维生长情况好于ATP组,但二者均优于NS组.第2,4,6,8周神经电生理及腓肠肌湿重NGF组优于ATP组,第4,6,8周坐骨神经指数、肌纤维直径及截面积NGF组优于ATP组(P＜0.05),且各时相点NGF组及ATP组的观测指标均明显优于NS组(P＜0.05). 结论 (1)联合应用NGF+ATP对神经损伤修复及失神经肌肉作用明显,优于单纯应用NGF及ATP;(2)单纯应用ATP对神经损伤修复及失神经肌肉有一定作用,但效果劣于NGF及NGF+ATP.
目的 探討腹腔聯閤應用鼠源性神經生長因子(NGF)及三燐痠腺苷(ATP)對週圍神經損傷脩複及失神經肌肉的作用. 方法 選取SD大白鼠96隻,體重(250±15)g,雌雄不限,按隨機數字錶法分為等滲鹽水組(NS組)、ATP組、NGF組、ATP+NGF組;選取大鼠坐骨神經,暴露後人為切斷造成3 mm缺損損傷,通過硅膠管連接兩神經斷耑,建立神經再生室.術後立即對各組分彆予以腹腔內註射等滲鹽水0.4 ml、ATP0.4 ml(1 mg/ml)、NGF0.4 ml(0.2 μg/ml)、NGF+ATP 0.4 ml(ATP 1 mg/ml、NGF 0.2 μg/ml),之後每3 d通過腹腔註射1次.在第2,4,6,8週各組分彆取6隻大門鼠行坐骨神經指數測定、大體觀察、坐骨神經肌電圖檢查,處死大鼠後切取標本觀察再生室區段神經再生狀況、腓腸肌濕重,HE染色觀察腓腸肌纖維直徑及截麵積. 結果 術後第2,4,6,8週各組分彆取6隻大白鼠測定實驗數據,NGF+ATP組坐骨神經指數、神經傳導速度、腓腸肌濕重優于NS組及單純ATP或NGF組(P＜0.05).大體觀察可見NGF+ATP組患側足趾紅腫程度較其餘三組輕,跼部潰爛亦相對少,未見足趾脫落者.術後2週,各組神經再生室內可見纖細神經纖維生長,但未將神經斷耑連接一起.術後4,6,8週,神經再生室內可見神經纖維通過,NGF+ATP組相對其餘三組神經纖維生長生長情況較好,且跼部炎性反應及纖維粘連輕.NGF組神經纖維生長情況好于ATP組,但二者均優于NS組.第2,4,6,8週神經電生理及腓腸肌濕重NGF組優于ATP組,第4,6,8週坐骨神經指數、肌纖維直徑及截麵積NGF組優于ATP組(P＜0.05),且各時相點NGF組及ATP組的觀測指標均明顯優于NS組(P＜0.05). 結論 (1)聯閤應用NGF+ATP對神經損傷脩複及失神經肌肉作用明顯,優于單純應用NGF及ATP;(2)單純應用ATP對神經損傷脩複及失神經肌肉有一定作用,但效果劣于NGF及NGF+ATP.
목적 탐토복강연합응용서원성신경생장인자(NGF)급삼린산선감(ATP)대주위신경손상수복급실신경기육적작용. 방법 선취SD대백서96지,체중(250±15)g,자웅불한,안수궤수자표법분위등삼염수조(NS조)、ATP조、NGF조、ATP+NGF조;선취대서좌골신경,폭로후인위절단조성3 mm결손손상,통과규효관련접량신경단단,건립신경재생실.술후립즉대각조분별여이복강내주사등삼염수0.4 ml、ATP0.4 ml(1 mg/ml)、NGF0.4 ml(0.2 μg/ml)、NGF+ATP 0.4 ml(ATP 1 mg/ml、NGF 0.2 μg/ml),지후매3 d통과복강주사1차.재제2,4,6,8주각조분별취6지대문서행좌골신경지수측정、대체관찰、좌골신경기전도검사,처사대서후절취표본관찰재생실구단신경재생상황、비장기습중,HE염색관찰비장기섬유직경급절면적. 결과 술후제2,4,6,8주각조분별취6지대백서측정실험수거,NGF+ATP조좌골신경지수、신경전도속도、비장기습중우우NS조급단순ATP혹NGF조(P＜0.05).대체관찰가견NGF+ATP조환측족지홍종정도교기여삼조경,국부궤란역상대소,미견족지탈락자.술후2주,각조신경재생실내가견섬세신경섬유생장,단미장신경단단련접일기.술후4,6,8주,신경재생실내가견신경섬유통과,NGF+ATP조상대기여삼조신경섬유생장생장정황교호,차국부염성반응급섬유점련경.NGF조신경섬유생장정황호우ATP조,단이자균우우NS조.제2,4,6,8주신경전생리급비장기습중NGF조우우ATP조,제4,6,8주좌골신경지수、기섬유직경급절면적NGF조우우ATP조(P＜0.05),차각시상점NGF조급ATP조적관측지표균명현우우NS조(P＜0.05). 결론 (1)연합응용NGF+ATP대신경손상수복급실신경기육작용명현,우우단순응용NGF급ATP;(2)단순응용ATP대신경손상수복급실신경기육유일정작용,단효과렬우NGF급NGF+ATP.
Objective To investigate the unification effect of rat nerve growth factor(NGF)and adenosine triphosphate(ATP)on repair of the peripheral nerve injury and the denervated muscle.Methods Ninety-six healthy SD rats weighing(250±15)g were randomly divided into NGF+ATP group,NGF group,ATP group and NS group.The sciatic nerves were cut for 3 mm,and were connected with silicone tube to create the nerve regeneration room.Then,all rats were intraperitoneally injected with NS0.4ml,ATP0.4ml(1 mg/ml),NGF 0.4 ml(0.2 μg/ml),NGF+ATP 0.4 ml(ATP1 mg/ml,NGF 0.2 μg/ml)separately once every three days.Six rats from each group were selected at 2,4,6 and 8 weeks after operation for sciatic nerve index(SFI)detection,gross observation and electrophysiological test;the specimens were obtained from the sacrificed rats for nerve regeneration,gastrocnemius muscle wet weight,fiber diameter and cross-sectional area of the gastrocnemius muscle(by HE staining).ResultsAt 2,4,6 and 8 weeks after operation,every six rats were chosen to be tested.The SFI,nerve conduction velocity and wet weight of the muscle of NGF+ATP group were better than those of the other three groups(P ＜ 0.05).The swelling of the rat toes of NGF+ATP group was slighter than that of NGF group and ATP group,with no loss of toes found in NGF+ATP group.At the 2nd week after operation,new nerve fibers were observed in the regeneration room,with no connection of the nerve fibers.The nerve fibers crossed the regeneration room at 4,6 and 8 weeks after operation.Compared with other three groups,the nerve growth condition was better in NGF+ATP group,with slighter adhesion and inflammation of nerve fibers.The growth condition of the nerve fibers of NGF group was better than ATP group,and that of NGF group and ATP group was better than NS group.At 2,4,6 and 8 weeks after operation,the electrophysiological condition and wet weight of muscle in NGF group was better than those in ATP group.While the SFI,the cross area and diameter of the muscle in NGF group were better than ATP group at 4,6 sand 8 weeks(P ＜ 0.05).All the parameters in NGF group and ATP group were better than NS group at each time point(P ＜ 0.05).Conclusions(1)The unification effect of NGF and ATP exert apparent effect in repair of the injured nerve and on the denervated muscle.Combined application of NGF and ATP is superior than NGF or ATP used alone.(2)A certain effect of ATP in repair of the injured nerve and on the denervated muscle is detected,but it is inferior to NGF and NGF+ATP.
