CAJ | 학술논문

背景:伤害性刺激可引起脊髓及背根神经节降钙素基因相关肽分泌的增多,及其微血管的强烈扩张.应用肢体负压治疗周围动脉闭塞性病变时,其扩张血管,减轻肢体疼痛症状的作用是否伴随着降钙素基因相关肽合成增多.目的:对周围动脉闭塞性病变犬行肢体负压干预后,检测脊髓及背根神经节中降钙素基因相关肽免疫反应阳性神经纤维的变化.设计:随机分组,实验组及空白组对照的验证性研究.单位:一所军医大学医院普外科.材料:实验于2003-01/08在第四军医大学西京医院完成.成年健康杂种犬17只,体质量(12～18)kg,雌雄不限.干预:犬17只,随机分为3组.①治疗组10只:将动物制作左后肢缺血模型,制作后14 d,开始行患肢负压治疗10 d,结束后,取L1～5的脊髓及背根神经节,行免疫组化染色,检测降钙素基因相关肽免疫反应阳性纤维.②单纯造模组5只:造模后不进行患肢负压治疗,处理、检查均同治疗组.③正常对照组2只:不行缺血模型制作及负压治疗,仅行免疫组化染色检测.主要观察指标:3组犬脊髓及背根神经节中降钙素基因相关肽免疫反应阳性纤维分布.结果:17只犬均进入结果分析.①脊髓及背根神经节中降钙素基因相关肽免疫反应阳性纤维单纯造模组明显高于治疗组和正常对照组[(75.00±4.30)%,(68.20±2.60)%;(58.20±5.10)%,(52.20±6.20)%;(37.00±4 20)%,(34.00±1.40)%,P＜0.01].②阳性神经纤维检测结果:治疗组比单纯造模组染色变浅,但仍较正常对照组加深,3组比较差异意义显著(P均＜0.01).结论:肢体负压疗法可以减少周围动脉闭塞性病变后脊髓及背根神经节中降钙素基因相关肽免疫反应阳性纤维的合成与痛觉的传递,即减少伤害性刺激的传入,从而达到缓解肢体疼痛的效果.
배경:상해성자격가인기척수급배근신경절강개소기인상관태분비적증다,급기미혈관적강렬확장.응용지체부압치료주위동맥폐새성병변시,기확장혈관,감경지체동통증상적작용시부반수착강개소기인상관태합성증다.목적:대주위동맥폐새성병변견행지체부압간예후,검측척수급배근신경절중강개소기인상관태면역반응양성신경섬유적변화.설계:수궤분조,실험조급공백조대조적험증성연구.단위:일소군의대학의원보외과.재료:실험우2003-01/08재제사군의대학서경의원완성.성년건강잡충견17지,체질량(12～18)kg,자웅불한.간예:견17지,수궤분위3조.①치료조10지:장동물제작좌후지결혈모형,제작후14 d,개시행환지부압치료10 d,결속후,취L1～5적척수급배근신경절,행면역조화염색,검측강개소기인상관태면역반응양성섬유.②단순조모조5지:조모후불진행환지부압치료,처리、검사균동치료조.③정상대조조2지:불행결혈모형제작급부압치료,부행면역조화염색검측.주요관찰지표:3조견척수급배근신경절중강개소기인상관태면역반응양성섬유분포.결과:17지견균진입결과분석.①척수급배근신경절중강개소기인상관태면역반응양성섬유단순조모조명현고우치료조화정상대조조[(75.00±4.30)%,(68.20±2.60)%;(58.20±5.10)%,(52.20±6.20)%;(37.00±4 20)%,(34.00±1.40)%,P＜0.01].②양성신경섬유검측결과:치료조비단순조모조염색변천,단잉교정상대조조가심,3조비교차이의의현저(P균＜0.01).결론:지체부압요법가이감소주위동맥폐새성병변후척수급배근신경절중강개소기인상관태면역반응양성섬유적합성여통각적전체,즉감소상해성자격적전입,종이체도완해지체동통적효과.
BACKGROUND: Harmful stimuli induce increased production of calcitonin gene-related peptide(CGRP) in the spinal cord and dorsal root ganglion, causing also intense dilation of the microvessels. But it remains unknown whether vessel dilation and pain relief were accompanied by increased CGRP production when negative pressure is applied on the limbs for treatment of peripheral arterial occlusion diseases (PAOD).OBJECTIVE: To examine the changes of calcitonin gene-related peptide (GGRP) -immunoractive nerve fibers in the spinal cord and dorsal root ganglion in dogs with PAOD treated with negative pressure on the limbs.DESIGN: A randomized controlled retrospective study.SETTING: The department of general surgery of a military medical university.MATERIALS: This study was carried out at Xijing Hospital of the Fourth Military Medical University of Chinese PLA between January and August 2003. Seventeen adult male dogs weighing 12 - 18 kg, regardless of the gender, were selected.INTERVENTIONS: Seventeen dogs were randomly divided into three groups, namely the treatment group( n = 10), model group( n = 5), and the normal control group( n = 2). Posterior left leg ischemia was induced in dogs in the treatment and model groups, and those in the treatment group, but not the model group, were treated with negative limb pressure for 10 days 14days after model establishment. The spinal cord and dorsal ganglion at L1-5of these two groups were collected and stained immunohistochemically for observing the changes of GGRP-immunreactive nerve fibers. The dogs in the normal control group were also sampled in similar manner for immunohistochemical staining.MAIN OUTCOME MEASURES: Distribution of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions of the three groups of dogs.RESULTS: In the dogs of the model group, GGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions was significantly more numerous[ (75. 00 ±4. 30)%, (68.20 ± 2.60)% ] than those in the treatment and normal control groups[ (58. 20 ±5. 10)%, (52. 20 ±6.20)%; (37.00±4. 20)%, (34. 00 ± 1.40)%, P ＜ 0.01]. The positive nerve fibers were less strongly stained in the treatment group than those in the model group,but still stronger stained those in the normal control group, with significant difference between the three groups( P ＜ 0.01).CONCLUSION: Negative pressure on the limbs may attenuate the synthesis of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal root ganglion and pain conduction following PAOD in dogs, so that harmful afferent stimuli are inhibited to relieve the pain in the limbs.