CAJ | 학술논문

背景：理想的脊髓损伤模型应既能模拟人类脊髓损伤，又能排除影响疗效的干扰因素，并具有广泛可重复性，脊髓全横断模型是目前较理想的选择。但由于操作方法的多样性致使疗效差异较大，各研究结果之间缺乏可比较性。目的：通过建立标准化的大鼠脊髓全横断模型，对比分析脊髓全横断大鼠后肢行为学改变和病理学特征。方法：成年雌性SD大鼠60只，随机分为假手术组(n=12)、常规脊髓横断组(n=24)和显微脊髓横断组(n=24)，每组再随机分为造模后7，14，28 d组。以T9椎体为中心，假手术组行椎板切除；其他两组行脊髓全横断，造成脊髓急性损伤模型，其中常规脊髓横断组采用常规外科方法造模，显微脊髓横断组采用标准化显微操作技术造模。各组于造模后7，14和28 d行后肢运动功能BBB评分及横断处脊髓的组织病理学观察，观测脊髓横断处瘢痕组织厚度、脊髓残端间距、空洞横径和脑脊液囊腔形成情况，计算瘢痕指数、残端间距指数和空洞指数。结果与结论：假手术组术前、术后BBB 评分和脊髓病理无明显变化。常规脊髓横断组和显微脊髓横断组大鼠造模后后肢完全性瘫痪，其中常规脊髓横断组大鼠后肢功能无恢复。造模后一至二周，显微脊髓横断组大鼠开始出现后肢运动功能自发性恢复，脊髓病理学检测指标值均明显低于常规脊髓横断组，差异有非常显著性意义(P <0.01)。各组病理学观测指标与 BBB 评分之间无相关关系。提示标准化脊髓全横断造模方法有利于消除个体差异，更有利于对治疗效果的量化分析和研究比较。
배경：이상적척수손상모형응기능모의인류척수손상，우능배제영향료효적간우인소，병구유엄범가중복성，척수전횡단모형시목전교이상적선택。단유우조작방법적다양성치사료효차이교대，각연구결과지간결핍가비교성。목적：통과건립표준화적대서척수전횡단모형，대비분석척수전횡단대서후지행위학개변화병이학특정。방법：성년자성SD대서60지，수궤분위가수술조(n=12)、상규척수횡단조(n=24)화현미척수횡단조(n=24)，매조재수궤분위조모후7，14，28 d조。이T9추체위중심，가수술조행추판절제；기타량조행척수전횡단，조성척수급성손상모형，기중상규척수횡단조채용상규외과방법조모，현미척수횡단조채용표준화현미조작기술조모。각조우조모후7，14화28 d행후지운동공능BBB평분급횡단처척수적조직병이학관찰，관측척수횡단처반흔조직후도、척수잔단간거、공동횡경화뇌척액낭강형성정황，계산반흔지수、잔단간거지수화공동지수。결과여결론：가수술조술전、술후BBB 평분화척수병리무명현변화。상규척수횡단조화현미척수횡단조대서조모후후지완전성탄탄，기중상규척수횡단조대서후지공능무회복。조모후일지이주，현미척수횡단조대서개시출현후지운동공능자발성회복，척수병이학검측지표치균명현저우상규척수횡단조，차이유비상현저성의의(P <0.01)。각조병이학관측지표여 BBB 평분지간무상관관계。제시표준화척수전횡단조모방법유리우소제개체차이，경유리우대치료효과적양화분석화연구비교。
BACKGROUND:Ideal models of spinal cord injury should simulate human spinal cord injury, exclude confounding factors affecting effects, and have extensive repeatability. Spinal cord transection model is an ideal choice at present. Nevertheless, the operation is diverse, so therapeutic effects have great differences, and the research results lack of comparability. OBJECTIVE:To compare and analyze behavioral changes and pathological features of rat hindlimb after spinal cord transection by establishing standardized model of transected spinal cord in rats. METHODS:A total of 60 adult female Sprague-Dawley rats were randomly divided into sham surgery group (n=12), conventional spinal cord transection group (n=24) and microscopic spinal cord transection group (n=24). Each group was randomly assigned to 7-day, 14-day and 28-day groups according to time points after model establishment. T9 vertebrae were considered as a center. Sham surgery group underwent laminectomy. Other groups underwent spinal cord transection. Thus, models of acute spinal cord injury were induced. Models in the conventional spinal cord transection group were established by conventional surgical methods. Models in the microscopic spinal cord transection group were established by standardization micromanipulation technique. At 7, 14 and 28 days after model establishment, motor function of hindlimb was evaluated using Basso, Beattie and Bresnahan (BBB) scoring system. Histopathology of transected spinal cord was observed. The thickness of the glial scar, the longitudinal distance between the two stumps, the transverse diameter of the spinal cord cavity and cerebrospinal fluid cyst formation were measured at the transected site of the spinal cord. RESULTS AND CONCLUSION:In the sham surgery group, preoperative and postoperative BBB scores and pathology of the spinal cord did not clearly change. In the conventional spinal cord transection group and microscopic spinal cord transection group, complete paralysis of hindlimb was detected after model establishment. Hindlimb function did not recover in the conventional spinal cord transection group. At 1 to 2 weeks after model induction, spontaneous recovery of hindlimb function was visible in rats of the microscopic spinal cord transection group. Spinal pathology index value was significantly lower in the microscopic spinal cord transection group than in the conventional spinal cord transection group (P<0.01). Pathological observations were not correlated with BBB scores in each group. These data indicated that standardized spinal cord transection method helps to eliminate individual differences and to quantitatively analyze and to compare studies addressing therapeutic effects.