CAJ | 학술논문

目的研究颈7神经根切断后主要靶肌肉内运动终板形态学的变化过程,探索颈7神经根切断术后的代偿机制.方法 42只雄性SD大鼠,随机分成7组,每组6只.同一只大鼠右侧建成颈7神经根切断模型,左侧为对照组.用乙酰胆碱酯酶染色、银-乙酰胆碱酯酶染色、免疫荧光染色和电镜等技术手段检测术后第1、2、4、6、8、12周大鼠的肱三头肌、背阔肌和指总伸肌内运动终板形态学的变化过程.所有数据均用SPSS 17.0软件进行均值、标准差计算和方差统计学分析.结果颈7神经根切断后1～3周,主要靶肌肉内运动终板的形态结构无明显变化.颈7神经根切断后4～8周,靶肌肉内某些区域出现少数面积明显增大,乙酰胆碱酯酶淡染,电镜下超微结构严重退变的运动终板.术后12周,运动终板结构得以恢复,并可能在老运动终板附近出现多个小的特化的突触后膜聚集区,以形成新的运动终板.结论颈7神经根切断后,靶肌肉内运动终板微观形态学会出现改变,并在术后12周基本恢复正常.而来源于邻近正常神经的轴突出芽可能是重要的颈7神经根切断术的代偿方式.
목적 연구경7신경근절단후주요파기육내운동종판형태학적변화과정,탐색경7신경근절단술후적대상궤제.방법 42지웅성SD대서,수궤분성7조,매조6지.동일지대서우측건성경7신경근절단모형,좌측위대조조.용을선담감지매염색、은-을선담감지매염색、면역형광염색화전경등기술수단검측술후제1、2、4、6、8、12주대서적굉삼두기、배활기화지총신기내운동종판형태학적변화과정.소유수거균용SPSS 17.0연건진행균치、표준차계산화방차통계학분석.결과 경7신경근절단후1～3주,주요파기육내운동종판적형태결구무명현변화.경7신경근절단후4～8주,파기육내모사구역출현소수면적명현증대,을선담감지매담염,전경하초미결구엄중퇴변적운동종판.술후12주,운동종판결구득이회복,병가능재로운동종판부근출현다개소적특화적돌촉후막취집구,이형성신적운동종판.결론 경7신경근절단후,파기육내운동종판미관형태학회출현개변,병재술후12주기본회복정상.이래원우린근정상신경적축돌출아가능시중요적경7신경근절단술적대상방식.
Objective To explore the compensatory mechanisms after severing the C7 nerve root by studying the morphological changes of motor end-plate in target muscles.Methods Forty-two male SD rats were randomly divided into 7 groups,with 6 each.C7 nerve root on the right side was transected while that on the left side was left intact.At 1,2,4,6,8,and 12 weeks after C7 nerve root transection,the triceps brachii,latissimus dorsi and extensor digitorum communis muscles of the experimental side and the normal side were harvested and subjected to acetylcholinesterase staining,silver-acetylcholinesterase staining,immunofluorescence staining and electron microscopy.The morphological changes of the motor end-plate in these muscles were recorded and analyzed.SPSS 17.0 software was used to calculate the mean,standard deviation and analysis of variance.Results Within 1 to 3 weeks of C7 transection,there were no significant morphological changes of the motor end-plate in target muscles.Between 4 to 8 weeks post transection,a small number of abnormal motor end-plates with features of larger area,lighter acetylcholinesterase staining and severe ultrastructural degeneration under electron microscopy emerged sparsely in some spots in the target muscles.The morphology of motor endplate returned to normal status 12 weeks following C7 transection.Multiple small specialized postsynaptic membrane aggregations appeared in the neighborhood of the original nerve terminal to form new motor end-plates.Conclusion Morphological changes of the motor end-plate happened in target muscles after C7 nerve root transection.These changes returned to normal in 12 weeks.Axonal sprouting derived from adjacent healthy nerve fibers could be the main mechanism of compensation in C7 nerve transfer.