国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2011年
4期
429-432
,共4页
术后持续性痛%脊髓%小胶质细胞%米诺环素
術後持續性痛%脊髓%小膠質細胞%米諾環素
술후지속성통%척수%소효질세포%미낙배소
Persistent postoperative pain%Spinal cord%Microglia%Minocycline
目的研究鞘内注射小胶质细胞活化特异性抑制剂米诺环素对皮肤/肌肉切口和牵拉（skin/muscle incision and retraction,SMIR）术后持续性痛大鼠机械缩足反射阈值（mechanical withdrwal threshold，MWT）的影响。方法选择鞘内置管成功的雄性SD大鼠32只，按随机数字表随机分为4组（每组8只）：正常对照组、假手术组、SMIR模型组和SMIR模型+米诺环素组（简称米诺环素组）。按Yaksh法鞘内置管；按Flatters法制作大鼠SMIR术后持续性痛模型；应用von Frey纤维细丝法测定MWT来评定疼痛行为学变化。结果与术前基础值和正常对照组比较，假手术组各时间点的MWT均无明显变化（术前基础值为13.0±0.9，正常对照组和假手术组在术前及术后第1、3、7、12、22、32天的MWT分别为13.2±0.9和13.0±0.9，13.2±0.7和12.9±1.0, 12.9±0.8和12.7±1.1,12.8±1.2和13.0±1.0，13.3±0.7和13.2±1.0，12.8±0.8和12.9±1.2，12.9±1.1和13.1±0.8,P＞0.05）；与术前基础值和假手术组相应时间点比较，SMIR模型组在术后第3、7、12、22天的MWT均明显下降（术前基础值为13.1±0.8，假手术组和SMIR模型组在术后第3、7、12、22天的MWT分别为12.7±1.1和9.1±03，13.0±1.0和7.8±1.0，13.2±1.0和5.4±1.0，12.9±1.2和9.0±0.4,P＜0.05)；与SMIR模型组相应时间点比较，米诺环素组在术后第3、7、12、22天的MWT明显增加（SMIR模型组和米诺环素组术后第3、7、12、22天的MWT分别为9.1±0.3和10.8±1.3，7.8±1.0和8.9±0.1，5.4±1.0和8.0±1.1，9.0±0.4和9.9±0.7，P＜0.05)。结论在大鼠SMIR术后持续性痛模型中，鞘内注射米诺环素可明显减轻SMIR引起的疼痛行为学变化，提示脊髓小胶质细胞的活化在术后持续性痛发生和发展中具有重要作用。
目的研究鞘內註射小膠質細胞活化特異性抑製劑米諾環素對皮膚/肌肉切口和牽拉（skin/muscle incision and retraction,SMIR）術後持續性痛大鼠機械縮足反射閾值（mechanical withdrwal threshold，MWT）的影響。方法選擇鞘內置管成功的雄性SD大鼠32隻，按隨機數字錶隨機分為4組（每組8隻）：正常對照組、假手術組、SMIR模型組和SMIR模型+米諾環素組（簡稱米諾環素組）。按Yaksh法鞘內置管；按Flatters法製作大鼠SMIR術後持續性痛模型；應用von Frey纖維細絲法測定MWT來評定疼痛行為學變化。結果與術前基礎值和正常對照組比較，假手術組各時間點的MWT均無明顯變化（術前基礎值為13.0±0.9，正常對照組和假手術組在術前及術後第1、3、7、12、22、32天的MWT分彆為13.2±0.9和13.0±0.9，13.2±0.7和12.9±1.0, 12.9±0.8和12.7±1.1,12.8±1.2和13.0±1.0，13.3±0.7和13.2±1.0，12.8±0.8和12.9±1.2，12.9±1.1和13.1±0.8,P＞0.05）；與術前基礎值和假手術組相應時間點比較，SMIR模型組在術後第3、7、12、22天的MWT均明顯下降（術前基礎值為13.1±0.8，假手術組和SMIR模型組在術後第3、7、12、22天的MWT分彆為12.7±1.1和9.1±03，13.0±1.0和7.8±1.0，13.2±1.0和5.4±1.0，12.9±1.2和9.0±0.4,P＜0.05)；與SMIR模型組相應時間點比較，米諾環素組在術後第3、7、12、22天的MWT明顯增加（SMIR模型組和米諾環素組術後第3、7、12、22天的MWT分彆為9.1±0.3和10.8±1.3，7.8±1.0和8.9±0.1，5.4±1.0和8.0±1.1，9.0±0.4和9.9±0.7，P＜0.05)。結論在大鼠SMIR術後持續性痛模型中，鞘內註射米諾環素可明顯減輕SMIR引起的疼痛行為學變化，提示脊髓小膠質細胞的活化在術後持續性痛髮生和髮展中具有重要作用。
목적연구초내주사소효질세포활화특이성억제제미낙배소대피부/기육절구화견랍（skin/muscle incision and retraction,SMIR）술후지속성통대서궤계축족반사역치（mechanical withdrwal threshold，MWT）적영향。방법선택초내치관성공적웅성SD대서32지，안수궤수자표수궤분위4조（매조8지）：정상대조조、가수술조、SMIR모형조화SMIR모형+미낙배소조（간칭미낙배소조）。안Yaksh법초내치관；안Flatters법제작대서SMIR술후지속성통모형；응용von Frey섬유세사법측정MWT래평정동통행위학변화。결과여술전기출치화정상대조조비교，가수술조각시간점적MWT균무명현변화（술전기출치위13.0±0.9，정상대조조화가수술조재술전급술후제1、3、7、12、22、32천적MWT분별위13.2±0.9화13.0±0.9，13.2±0.7화12.9±1.0, 12.9±0.8화12.7±1.1,12.8±1.2화13.0±1.0，13.3±0.7화13.2±1.0，12.8±0.8화12.9±1.2，12.9±1.1화13.1±0.8,P＞0.05）；여술전기출치화가수술조상응시간점비교，SMIR모형조재술후제3、7、12、22천적MWT균명현하강（술전기출치위13.1±0.8，가수술조화SMIR모형조재술후제3、7、12、22천적MWT분별위12.7±1.1화9.1±03，13.0±1.0화7.8±1.0，13.2±1.0화5.4±1.0，12.9±1.2화9.0±0.4,P＜0.05)；여SMIR모형조상응시간점비교，미낙배소조재술후제3、7、12、22천적MWT명현증가（SMIR모형조화미낙배소조술후제3、7、12、22천적MWT분별위9.1±0.3화10.8±1.3，7.8±1.0화8.9±0.1，5.4±1.0화8.0±1.1，9.0±0.4화9.9±0.7，P＜0.05)。결론재대서SMIR술후지속성통모형중，초내주사미낙배소가명현감경SMIR인기적동통행위학변화，제시척수소효질세포적활화재술후지속성통발생화발전중구유중요작용。
objective To observe the effects of intrathecal minocycline (a selective inhibitor of microglia activation) on mechanical withdrawal threshold (MWT) in a rat model of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR). Methods 32 male Sprague-Dawley rats were randomly divided into four groups according to random number table (n=8):normal control group, sham operation group, SMIR model group and SMIR model plus intrathecal minocycline group(minocycline group). A PE-10 catheter was inserted into the subarachnoid space(intrathecal) according to the method described by Yaksh et al. A rat model of persistent postoperative pain evoked by SMIR was made according to the method described by Flatters. Pain behavior was assessed by MWT to yon Frey filament stimulation intensity. Results Compared with both preoperative baseline and normal control group, the MWT of sham operation group did not change significantly at each time point (preoperative baseline: 13.0±0.9, the MWT of normal control group and sham operation group before operation and at postoperative days 1, 3, 7, 12, 22 and 32 were 13.2±0.9 and 13.0±0.9, 13.2±0.7 and 12.9±1.0, 12.9±0.8 and 12.7±1.1, 12.8±1.2 and 13.0±1.0, 13.3±0.7 and 13.2±1.0, 12.8±0.8 and 12.9±1.2, 12.9±1.1 and 13.1±0.8, respectively, P＞0.05). However, compared with both preoperative baseline and sham operation group, the MWT of SMIR model group decreased significantly at postoperative days 3, 7, 12 and 22 (preoperative baseline: 13.1±0.8, the MWT of sham operation group and SMIR model group at postoperative days 3, 7, 12 and 22 were 12.7±1.1 and 9.1±0.3, 13.0±1.0 and 7.8±1.0, 13.2±1.0 and 5.4±1.0, 12.9±1.2 and 9.0±0.4, respectively, P＜0.05); Compared with SMIR model group, the MWT of minocycline group increased significantly at postoperative days 3, 7, 12 and 22 (the MWT of SMIR model group and minocycline group at postoperative days 3, 7, 12 and 22 were 9.1±0.3 and 10.8±1.3, 7.8±1.0 and 8.9±0.1, 5.4±1.0 and 8.0±1.1, 9.0±0.4 and 9.9 ±0.7, respectively, P＜0.05). Conclusion Intrathecal minocycline markedly attenuates pain symptoms in a rat model of persistent postoperative pain evoked by SMIR, which suggests that activated spinal microglia plays an important role in the development and maintenance of persistent postoperative pain.
