中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
5期
426-431
,共6页
王凯丰%刘海鹰%王波%王会民%钱亚龙%朱震奇%缪克难%张恒维
王凱豐%劉海鷹%王波%王會民%錢亞龍%硃震奇%繆剋難%張恆維
왕개봉%류해응%왕파%왕회민%전아룡%주진기%무극난%장항유
脊髓损伤%甲泼尼龙琥珀酸酯%注射,脊髓%细胞凋亡
脊髓損傷%甲潑尼龍琥珀痠酯%註射,脊髓%細胞凋亡
척수손상%갑발니룡호박산지%주사,척수%세포조망
Spinal cord injuries%Methylprednisolone hemisuccinate%Injection,spinal%Apoptosis
目的 研究甲泼尼龙琥珀酸钠(MPss)鞘内注射治疗新两兰兔急性脊髓损伤的疗效及神经元凋亡情况.方法 选取健康新西兰兔72只,随机分为急性脊髓损伤组(SCI组)及假手术组(SHAM组),每组分成1~6亚组,分别给予生理盐水、鞘内注射MPss、静脉注射MPss及联合应用鞘内及静脉注射MPss治疗.术后每天行TARLOV下肢运动功能评分,7 d处死实验动物,取脊髓损伤、假手术部位及鞘内注射部位神经组织标本,予以HE染色和TUNEL染色.不同时间点TARLOV评分比较应用两因素重复测量资料方差分析,组间应用单因素方差分析进行统计学处理.结果 术后7d时,SCI组鞘内注射MPss 3.0 mg/kg、6.0 mg/kg与传统静脉注射治疗的TARLOV评分差异无统计学意义(P>0.05),且均高于生理盐水对照组(F =4.762,P<0.05);SCI组鞘内注射MPss 6.0 mg/kg的脊髓损伤部位淋巴细胞浸润评分为(1.33±0.21)分,与生理盐水对照组的(2.67±0.21)分比较差异有统计学意义(F=5.793,P<0.05),与传统静脉注射治疗差异无统计学意义(P>0.05).SHAM组鞘内注射MPss 6.0 mg/kg的鞘内注射部位淋巴细胞浸润评分为(2.50±0.55)分,与生理盐水对照组的(0.50±0.55)分比较差异有统计学意义(F=17.333,P<0.05);SCI组TUNEL染色提示鞘内注射6.0 mg/kg的凋亡细胞计数[(6.3±1.5)个]与生理盐水对照组[(20.3 ±2.2)个]比较差异有统计学意义(F=71.279,P<0.05).结论 鞘内注射MPss可以改善新西兰兔急性脊髓损伤后下肢运动功能,取得与传统静脉冲击治疗相似的疗效,对抗神经细胞凋亡,改善脊髓损伤预后.
目的 研究甲潑尼龍琥珀痠鈉(MPss)鞘內註射治療新兩蘭兔急性脊髓損傷的療效及神經元凋亡情況.方法 選取健康新西蘭兔72隻,隨機分為急性脊髓損傷組(SCI組)及假手術組(SHAM組),每組分成1~6亞組,分彆給予生理鹽水、鞘內註射MPss、靜脈註射MPss及聯閤應用鞘內及靜脈註射MPss治療.術後每天行TARLOV下肢運動功能評分,7 d處死實驗動物,取脊髓損傷、假手術部位及鞘內註射部位神經組織標本,予以HE染色和TUNEL染色.不同時間點TARLOV評分比較應用兩因素重複測量資料方差分析,組間應用單因素方差分析進行統計學處理.結果 術後7d時,SCI組鞘內註射MPss 3.0 mg/kg、6.0 mg/kg與傳統靜脈註射治療的TARLOV評分差異無統計學意義(P>0.05),且均高于生理鹽水對照組(F =4.762,P<0.05);SCI組鞘內註射MPss 6.0 mg/kg的脊髓損傷部位淋巴細胞浸潤評分為(1.33±0.21)分,與生理鹽水對照組的(2.67±0.21)分比較差異有統計學意義(F=5.793,P<0.05),與傳統靜脈註射治療差異無統計學意義(P>0.05).SHAM組鞘內註射MPss 6.0 mg/kg的鞘內註射部位淋巴細胞浸潤評分為(2.50±0.55)分,與生理鹽水對照組的(0.50±0.55)分比較差異有統計學意義(F=17.333,P<0.05);SCI組TUNEL染色提示鞘內註射6.0 mg/kg的凋亡細胞計數[(6.3±1.5)箇]與生理鹽水對照組[(20.3 ±2.2)箇]比較差異有統計學意義(F=71.279,P<0.05).結論 鞘內註射MPss可以改善新西蘭兔急性脊髓損傷後下肢運動功能,取得與傳統靜脈遲擊治療相似的療效,對抗神經細胞凋亡,改善脊髓損傷預後.
목적 연구갑발니룡호박산납(MPss)초내주사치료신량란토급성척수손상적료효급신경원조망정황.방법 선취건강신서란토72지,수궤분위급성척수손상조(SCI조)급가수술조(SHAM조),매조분성1~6아조,분별급여생리염수、초내주사MPss、정맥주사MPss급연합응용초내급정맥주사MPss치료.술후매천행TARLOV하지운동공능평분,7 d처사실험동물,취척수손상、가수술부위급초내주사부위신경조직표본,여이HE염색화TUNEL염색.불동시간점TARLOV평분비교응용량인소중복측량자료방차분석,조간응용단인소방차분석진행통계학처리.결과 술후7d시,SCI조초내주사MPss 3.0 mg/kg、6.0 mg/kg여전통정맥주사치료적TARLOV평분차이무통계학의의(P>0.05),차균고우생리염수대조조(F =4.762,P<0.05);SCI조초내주사MPss 6.0 mg/kg적척수손상부위림파세포침윤평분위(1.33±0.21)분,여생리염수대조조적(2.67±0.21)분비교차이유통계학의의(F=5.793,P<0.05),여전통정맥주사치료차이무통계학의의(P>0.05).SHAM조초내주사MPss 6.0 mg/kg적초내주사부위림파세포침윤평분위(2.50±0.55)분,여생리염수대조조적(0.50±0.55)분비교차이유통계학의의(F=17.333,P<0.05);SCI조TUNEL염색제시초내주사6.0 mg/kg적조망세포계수[(6.3±1.5)개]여생리염수대조조[(20.3 ±2.2)개]비교차이유통계학의의(F=71.279,P<0.05).결론 초내주사MPss가이개선신서란토급성척수손상후하지운동공능,취득여전통정맥충격치료상사적료효,대항신경세포조망,개선척수손상예후.
Objective To investigate the effects and apoptosis of intrathecal injection of Methylprednisolone Sodium Succinate (MPss) for acute spinal cord injury (SCI) in New Zealand rabbits.Methods Seventy-two healthy New Zealand rabbits were used for the procedure and were randomly divided into two groups:SCI group and SHAM group,which was both divided into 6 subgroups,such as the vehicle group,the MPss intrathecal injection groups (1.5 mg/kg,3.0 mg/kg,6.0 mg/kg group),the MPss intravenous injection group and the combined injection group.TARLOV score was tested daily to evaluate the motor function.The rabbits were sacrificed 7 days after the surgery and the thoracic spinal cord sections and the sacral sections where MPss was injected were harvested for HE and TUNEL staining.Two-Factors Repeated Measures analysis of variance for TARLOV scores tested at various times and One-Way ANOVA analysis of variance for data between groups were used.Results Seven days after surgery in SCI group,there was no statistical difference between the TARLOV scores of intrathecal injection of MPss 3.0 mg/kg group,6.0 mg/kg group and MPss intravenous injection group (P > 0.05),which were all better than the vehicle group (F =4.762,P < 0.05).Referring to the lymphocyte infiltration at the injury site in SCI group,there was statistical difference between MPss intrathecal injection 6.0 mg/kg group(1.33 ± 0.21) and the vehicle group (2.67 ± 0.21) (F =5.793,P < 0.05) and no statistical difference between intrathecal injection of MPss 6.0 mg/kg group and MPss intravenous injection group (P > 0.05).As for the lymphocyte infiltration at the intratheeal injection site in SHAM group,there was statistical difference between MPss intrathecal injection 6.0 mg/kg group (2.50 ± 0.55) and the vehicle group (0.50 ± 0.55) (F =17.333,P <0.05).TUNEL staining in SCI group showed statistical difference between MPss intrathecal injection 6.0 mg/kg group (6.3 ± 1.5) and the vehicle group (20.3 ± 2.2) (F =71.279,P < 0.05).Conclusions lntrathecal injection of MPss can improve the functional recovery of lower limb and decrease apoptosis of neuron cells,which can provide same effects as the traditional intravenous injection of MPss in New Zealand rabbits.