CAJ | 학술논문

背景:周围动脉闭塞性病变是一种常见的周围动脉疾病,发病机制及病变过程尚不完全明确,其临床症状多较重,且治疗效果不佳.目的:观察肢体负压对周围动脉闭塞性病变犬中枢神经脊髓及背根神经节中P物质免疫反应阳性神经纤维的影响.设计:随机对照的实验研究.单位:武警陕西总队医院麻醉科和解放军第四军医大学西京医院普外三科. 对象:实验于2003-04/2004-05在解放军第四军医大学西京医院动物实验室完成.选用健康杂种清洁级犬17只,体质量12～18kg,动物编号后,按随机数字表法分为3组,治疗组10只,非治疗组5只,正常对照组2只.方法:将治疗组动物制作左后肢缺血模型,在造模后14 d开始行患肢负压治疗,1次/d,15 min/次,负压治疗10 d后行动物灌注.分别切取L1～L5的脊髓及背根神经节,行免疫组织化学染色,检测P物质免疫反应阳性神经纤维;非治疗组除不进行患肢负压治疗外,处理、检查均同治疗组.正常对照组不行缺血模型制作及负压治疗,仅行免疫组织化学染色检测.主要观察指标:各组犬脊髓及背根神经节的感觉神经纤维中P物质的变化.结果:非治疗组脊髓及背根神经节中,患侧P物质免疫反应阳性纤维(平均灰度值分别为:70.20±3.70,67.00±3.30)较正常对照组(20.00±2.80,35.50±6.40)染色明显加深,而治疗组(48.50±6.60,51.70±4.00)较非治疗组染色变浅,但仍较正常对照组加深(P均＜0.01).结论:周围动脉闭塞性疾病发病后,脊髓及背根神经节中的P物质免疫反应阳性神经纤维数量明显增多,可能是机体的一种自身保护机制.肢体负压疗法可减少肢体动脉闭塞性病变伤害性刺激的传入,缓解肢体疼痛.
배경:주위동맥폐새성병변시일충상견적주위동맥질병,발병궤제급병변과정상불완전명학,기림상증상다교중,차치료효과불가.목적:관찰지체부압대주위동맥폐새성병변견중추신경척수급배근신경절중P물질면역반응양성신경섬유적영향.설계:수궤대조적실험연구.단위:무경협서총대의원마취과화해방군제사군의대학서경의원보외삼과. 대상:실험우2003-04/2004-05재해방군제사군의대학서경의원동물실험실완성.선용건강잡충청길급견17지,체질량12～18kg,동물편호후,안수궤수자표법분위3조,치료조10지,비치료조5지,정상대조조2지.방법:장치료조동물제작좌후지결혈모형,재조모후14 d개시행환지부압치료,1차/d,15 min/차,부압치료10 d후행동물관주.분별절취L1～L5적척수급배근신경절,행면역조직화학염색,검측P물질면역반응양성신경섬유;비치료조제불진행환지부압치료외,처리、검사균동치료조.정상대조조불행결혈모형제작급부압치료,부행면역조직화학염색검측.주요관찰지표:각조견척수급배근신경절적감각신경섬유중P물질적변화.결과:비치료조척수급배근신경절중,환측P물질면역반응양성섬유(평균회도치분별위:70.20±3.70,67.00±3.30)교정상대조조(20.00±2.80,35.50±6.40)염색명현가심,이치료조(48.50±6.60,51.70±4.00)교비치료조염색변천,단잉교정상대조조가심(P균＜0.01).결론:주위동맥폐새성질병발병후,척수급배근신경절중적P물질면역반응양성신경섬유수량명현증다,가능시궤체적일충자신보호궤제.지체부압요법가감소지체동맥폐새성병변상해성자격적전입,완해지체동통.
BACKGROUND: Peripheral arterial occlusive disease is a kind of commonly seen peripheral arterial disease. Its pathogenesy and process of pathological change are still unclear. Most of its clinical symptoms are very severe and therapeutic effect is not very good.OBJECTIVE: To observe the effect of limb negative pressure on substance P (SP)-positive-immunoreactive nerve fibers in the spinal cord and dorsal root ganglion of dogs with peripheral arterial occlusive disease.DESIGN: A randomized and controlled experimental trial.SETTING: Department of Anesthesiology, Shaanxi Provincial Corps Hospital, Chinese People's Armed Police Forces; Third Department of General Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the animal laboratory,Xijing Hospital, Fourth Military Medical University of Chinese PLA between April 2003 and May 2004. Totally 17 healthy hybrid dogs, of clean degree, weighing 12 to 18 kg, were enrolled in the experiment. After being numbered, they were randomly divided into 3 groups: treated group (n=10),non-treated group (n=5) and normal control group (n=2).METHODS: Left hindlimb ischemia models were created on the animals in the treated group. Fourteen days after modeling, the affected limbs were treated by negative pressure, once a day, 15 minutes once. Perfusion was given 10 days after negative pressure treatment. Segment L1-L5 spinal cord and dorsal root ganglion were dissected respectively. Immunohistochemical staining was conducted to detect SP-positive- immunoreactive nerve fibers;In the non-treated group, treatment and detection of affected limbs were performed as those in the treated group, but negative pressure treatment was omitted. Ischemia model preparation and negative pressure treatment were not conducted in the normal control group, and only immunohistochemical staining was given.MAIN OUTCOME MEASURES: Changes in SP of sensory nerve fiber of spinal cord and dorsal root ganglion of dogs among 3 groups RESULTS: The dyeing of SP-positive-immunoactive nerve fibers of spinal cord and dorsal root ganglion at affected sides in non-treated group (mean gray scale value: 70.20 ±3.70,67.00 ±3.30 respectively )was significantly stronger than that in normal control group (20.00 ±2.80,35.50 ±6.40),while that in treated group (48.50±6.60,51.70±4.00) was weaker than that in non-treated group, but was still stronger than that in normal control group (all P ＜ 0.01).CONCLUSION: The number of SP-positive-immunoactive nerve fibers of spinal cord and dorsal root ganglion following peripheral arterial occlusive disease is increased significantly, which might be a kind of self-protective mechanism of organism. Limb negative pressure can reduce the importation of nocuous stimulation and release limb pain following arterial occlusive disease of limbs.