CAJ | 학술논문

目的：探讨不同时间电针刺激对大鼠脊髓损伤后磁共振弥散张量纤维束成像(DTT)部分各向异性值(FA)均值的影响。方法将48只清洁级Sprague-Dawley大鼠用NYU打击器制成T10-11段脊髓损伤模型。造模成功后随机分为对照组(n=16)和实验组(n=32)。对照组不进行电针刺激。实验组采用运动区头皮表面投影区电刺激，并结合局部电刺激。实验组又分为实验1组和实验2组。实验1组3 d时开始电针刺激，实验2组2周时开始电针刺激。各组分别于造模后1周、2周和4周进行Basso-Beattie-Bresnahan (BBB)评分。于造模后2~4 h、3 d及治疗后4周进行磁共振弥散张量成像(DTI)检测，测量脊髓损伤区域及正常区域的FA均值，分析比较电针治疗不同时间间BBB评分及FA均值的变化。并通过DTT观察不同时间电针刺激后纤维束的形态变化。结果实验组和对照组在第1周各组间BBB评分无显著性差异(P>0.05)，在第4周实验组BBB评分显著高于对照组(P<0.001)。在第2周和第4周，实验1组显著高于实验2组(P<0.001)。实验组与对照组在2~4 h和3 d各组间FA均值无显著性差异(P>0.05)，造模后4周有非常高度显著性差异(P<0.001)。实验1组优于实验2组(P<0.05)。各组在伤后2~4 h和治疗后4周的DTT清晰显示，实验组纤维束修复程度均好于对照组。结论脊髓损伤后电针刺激介入的时间越早，治疗效果越好。
목적：탐토불동시간전침자격대대서척수손상후자공진미산장량섬유속성상(DTT)부분각향이성치(FA)균치적영향。방법장48지청길급Sprague-Dawley대서용NYU타격기제성T10-11단척수손상모형。조모성공후수궤분위대조조(n=16)화실험조(n=32)。대조조불진행전침자격。실험조채용운동구두피표면투영구전자격，병결합국부전자격。실험조우분위실험1조화실험2조。실험1조3 d시개시전침자격，실험2조2주시개시전침자격。각조분별우조모후1주、2주화4주진행Basso-Beattie-Bresnahan (BBB)평분。우조모후2~4 h、3 d급치료후4주진행자공진미산장량성상(DTI)검측，측량척수손상구역급정상구역적FA균치，분석비교전침치료불동시간간BBB평분급FA균치적변화。병통과DTT관찰불동시간전침자격후섬유속적형태변화。결과실험조화대조조재제1주각조간BBB평분무현저성차이(P>0.05)，재제4주실험조BBB평분현저고우대조조(P<0.001)。재제2주화제4주，실험1조현저고우실험2조(P<0.001)。실험조여대조조재2~4 h화3 d각조간FA균치무현저성차이(P>0.05)，조모후4주유비상고도현저성차이(P<0.001)。실험1조우우실험2조(P<0.05)。각조재상후2~4 h화치료후4주적DTT청석현시，실험조섬유속수복정도균호우대조조。결론척수손상후전침자격개입적시간월조，치료효과월호。
Objective To explore the effects of electroacupuncture in different time on the variations of fractional anisotropy (FA) mean value in diffusion tensor tractography (DTT) in spinal cord injured (SCI) rats. Methods 48 Sprague-Dawley rats were performed with Al-len's method by NYU blow device, resulting in T10-11 SCI. They were divided into groups according to random table. Control group (n=16) re-ceived no treatment. Experimental group (Group A, n=32) received electric stimulation in the scalp surface projection area of motor area and local electric stimulation at damaged site. Group A was divided into Group A1 (n=16) and Group A2 (n=16) again. Group A1 received elec-tric stimulation 3 days after SCI, while Group A2 received electric stimulation 2 weeks after SCI. They were assessed with Basso-Beattie-Bresnahan (BBB) scores and routine MRI and diffusion tensor imaging (DTI). Results There was no significant difference in BBB score among all the groups at the first week (P>0.05). BBB scores of the Groups A1 and A2 were significantly different from the control group at the second and fourth week (P<0.001), and the Groups A1 from A2 (P<0.001). 2~4 hours and 3 days after modeling, there was no signifi-cant difference in the FA value among the groups (P>0.05). There was significant difference among the Groups A1, A2 and the control group at the fourth week (P<0.001). Group A1 was better than Group A2 (P<0.001). DTT images of all the groups were successful recon-structed, the Groups A1 and A2 repaired better than the control group. Conclusion The earlier electroacupuncture is taken after spinal cord injury, the better the outcome is.