中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2008年
7期
433-436
,共4页
王红星%徐冬晨%姚莉%雷晓婷%刘兴波%丁新生%王彤
王紅星%徐鼕晨%姚莉%雷曉婷%劉興波%丁新生%王彤
왕홍성%서동신%요리%뢰효정%류흥파%정신생%왕동
脊髓损伤%运动功能%脊髓诱发电位
脊髓損傷%運動功能%脊髓誘髮電位
척수손상%운동공능%척수유발전위
Spinal cord injury%Locomotor function%Somatosensory evoked potential
目的 观察不完全脊髓损伤(SCI)大鼠运动及神经功能自然恢复情况,为SCI后运动训练时机选择提供依据.方法 共选取45只成年SD大鼠,分为实验组(40只)和假手术组(5只).实验组手术切除T10椎板暴露脊髓,采用改良Allen's撞击法致SCI;假手术组仅手术切除T10椎板暴露脊髓.实验组分别于损伤前及损伤后1,3,5,7,14 d,21 d和28 d,假手术组分别于术前及术后1,3,5,7 d时采用斜板试验、改良Tarlov评分、Basso-Beattie-Bresnahan(BBB)评分进行运动功能评定,采用脊髓诱发电位评定神经功能.实验组于上述各时间点分别取5只大鼠处死,假手术组于术后7 d时处死,取2组大鼠T10节段脊髓进行形态学检测.结果 ①实验组大鼠在损伤后1～3 d斜板角度、改良Tarlov评分和BBB评分均较损伤前显著降低,自损伤后5 d时开始增加,至14 d时达到平台期,显著高于术后1,3,5 d及7 d时水平(P＜0.05),与21,28 d时结果比较,差异无统计学意义(P＞0.05),但仍低于损伤前水平(P＜0.05).假手术组术后与术前比较,差异均无统计学意义(P＞0.05).②实验组大鼠在损伤后1 d时脊髓体感诱发电位(SCEP)潜伏期较损伤前明显延长(P＜0.05);随时间进展该潜伏期呈逐渐缩短趋势,至术后21 d时达到平台期,但仍显著长于损伤前水平(P＞0.05);波幅在损伤后1 d时明显降低.随时间进展呈逐渐增加趋势;假手术组术后各时间点潜伏期和波幅与术前比较,差异均无统计学意义(P＞0.05).③2组大鼠术前脊髓结构完整,实验组术后1～3 d脊髓灰白质可见片状出血、细胞肿胀及变性;术后5～7 d炎性细胞减少,可见细胞内嗜碱性颗粒沉积、胶质细胞及少量神经纤维增生等;术后14～28 d可见胶质细胞、神经纤维增生明显,细胞内有空泡结构形成;假手术组大鼠脊髓形态学方面手术前后无明显改变.结论 SCI大鼠运动功能、神经功能及脊髓病理形态学变化均与损伤时程密切相关,其运动功能改善一般于损伤后14 d时达到平台期,而神经功能改善一般于损伤后21 d时达到平台期.
目的 觀察不完全脊髓損傷(SCI)大鼠運動及神經功能自然恢複情況,為SCI後運動訓練時機選擇提供依據.方法 共選取45隻成年SD大鼠,分為實驗組(40隻)和假手術組(5隻).實驗組手術切除T10椎闆暴露脊髓,採用改良Allen's撞擊法緻SCI;假手術組僅手術切除T10椎闆暴露脊髓.實驗組分彆于損傷前及損傷後1,3,5,7,14 d,21 d和28 d,假手術組分彆于術前及術後1,3,5,7 d時採用斜闆試驗、改良Tarlov評分、Basso-Beattie-Bresnahan(BBB)評分進行運動功能評定,採用脊髓誘髮電位評定神經功能.實驗組于上述各時間點分彆取5隻大鼠處死,假手術組于術後7 d時處死,取2組大鼠T10節段脊髓進行形態學檢測.結果 ①實驗組大鼠在損傷後1～3 d斜闆角度、改良Tarlov評分和BBB評分均較損傷前顯著降低,自損傷後5 d時開始增加,至14 d時達到平檯期,顯著高于術後1,3,5 d及7 d時水平(P＜0.05),與21,28 d時結果比較,差異無統計學意義(P＞0.05),但仍低于損傷前水平(P＜0.05).假手術組術後與術前比較,差異均無統計學意義(P＞0.05).②實驗組大鼠在損傷後1 d時脊髓體感誘髮電位(SCEP)潛伏期較損傷前明顯延長(P＜0.05);隨時間進展該潛伏期呈逐漸縮短趨勢,至術後21 d時達到平檯期,但仍顯著長于損傷前水平(P＞0.05);波幅在損傷後1 d時明顯降低.隨時間進展呈逐漸增加趨勢;假手術組術後各時間點潛伏期和波幅與術前比較,差異均無統計學意義(P＞0.05).③2組大鼠術前脊髓結構完整,實驗組術後1～3 d脊髓灰白質可見片狀齣血、細胞腫脹及變性;術後5～7 d炎性細胞減少,可見細胞內嗜堿性顆粒沉積、膠質細胞及少量神經纖維增生等;術後14～28 d可見膠質細胞、神經纖維增生明顯,細胞內有空泡結構形成;假手術組大鼠脊髓形態學方麵手術前後無明顯改變.結論 SCI大鼠運動功能、神經功能及脊髓病理形態學變化均與損傷時程密切相關,其運動功能改善一般于損傷後14 d時達到平檯期,而神經功能改善一般于損傷後21 d時達到平檯期.
목적 관찰불완전척수손상(SCI)대서운동급신경공능자연회복정황,위SCI후운동훈련시궤선택제공의거.방법 공선취45지성년SD대서,분위실험조(40지)화가수술조(5지).실험조수술절제T10추판폭로척수,채용개량Allen's당격법치SCI;가수술조부수술절제T10추판폭로척수.실험조분별우손상전급손상후1,3,5,7,14 d,21 d화28 d,가수술조분별우술전급술후1,3,5,7 d시채용사판시험、개량Tarlov평분、Basso-Beattie-Bresnahan(BBB)평분진행운동공능평정,채용척수유발전위평정신경공능.실험조우상술각시간점분별취5지대서처사,가수술조우술후7 d시처사,취2조대서T10절단척수진행형태학검측.결과 ①실험조대서재손상후1～3 d사판각도、개량Tarlov평분화BBB평분균교손상전현저강저,자손상후5 d시개시증가,지14 d시체도평태기,현저고우술후1,3,5 d급7 d시수평(P＜0.05),여21,28 d시결과비교,차이무통계학의의(P＞0.05),단잉저우손상전수평(P＜0.05).가수술조술후여술전비교,차이균무통계학의의(P＞0.05).②실험조대서재손상후1 d시척수체감유발전위(SCEP)잠복기교손상전명현연장(P＜0.05);수시간진전해잠복기정축점축단추세,지술후21 d시체도평태기,단잉현저장우손상전수평(P＞0.05);파폭재손상후1 d시명현강저.수시간진전정축점증가추세;가수술조술후각시간점잠복기화파폭여술전비교,차이균무통계학의의(P＞0.05).③2조대서술전척수결구완정,실험조술후1～3 d척수회백질가견편상출혈、세포종창급변성;술후5～7 d염성세포감소,가견세포내기감성과립침적、효질세포급소량신경섬유증생등;술후14～28 d가견효질세포、신경섬유증생명현,세포내유공포결구형성;가수술조대서척수형태학방면수술전후무명현개변.결론 SCI대서운동공능、신경공능급척수병리형태학변화균여손상시정밀절상관,기운동공능개선일반우손상후14 d시체도평태기,이신경공능개선일반우손상후21 d시체도평태기.
Objective To observe the natural recovery of locomotor and neurological functioning in rats after incomplete spinal cord injury. Methods Forty-five Sprague-Dawley rats were divided into two groups:an experimental group and a sham-operation group.In the experimental group,the spinal cord was exposed at the T10 level by laminectomy,and an animal model of spinal cord injury(SCI)was created using a modification of Allen's method.The sham-operation group received only laminectomy without spinal cord injury.Locomotor and neurological functioning were evaluated using inclined plane tests,modified Tarlov scores,Basso-Beattie-Bresnahan(BBB)scales and spinal cord evoked potential(SCEP)before the operation and on the 1st,3rd,5th,7th,14th,21 st and 28th day post surgery.Histomorphological changes were observed by light microscopy. Results (1)In the experimental group,the angles of the inclined plane test and the Tarlov and BBB scores had decreased significantly 1 and 3 days post-injury compared with those before the injury,and then increased gradually from the 5 th day onwards,and peaking at the 14th day after injury.In the sham-operation group no significant changes in the inclined plane test results,modified Tarlov scores or BBB scores were observed 1,3,5 or 7 days post surgery.(2)In experimental group,SCEP latency had increased significantly on the 1 st day after SCI,but it then decreased gradually until reaching a plateau at the 21 st day after the operation.The SCEP amplitude also decreased significantly at the 1st day after SCI,then increased gradually from the 3rd tO the 21 st day.In the sham-operation group,no significant changes in SCEP latency or amplitude were observed.(3)One and 3 days after the operation,hemorrhage and edema in the spinal cord as well as nerve fiber degeneration was observed in the experimental group.From day 5 to day 7,empty cavities formed gradually and astrocytes increased,a few nerve fibers grew.By days 14 and 28,more nerve fibers and astrocytes were found.Conclusion The recovery of locomotor and neurologic function correlated closely with the natural coupe of spinal cord recovery,and becomes stable 14 to 21 days after injury.
