蛛网膜下腔移植嗜铬细胞镇痛的耐受性研究  

The study of tolerance phenomenon of intrathecal analgesia after subarachnoid transplantation with chromaffin cells

作　　者：杨茂元[1] 毕好生[1] 段秋红[2] 汤红[1] 

机构地区：[1]同济医科大学附属同济医院麻醉学教研室,武汉市430030 [2]同济医科大学生物化学教研室

出　　处：《临床麻醉学杂志》2001年第5期267-269,共3页Journal of Clinical Anesthesiology

基　　金：国家自然科学研究基金 ( 3990 0 139) ;卫生部科研基金( 98 1 12 9)

摘　　要：目的　观察嗜铬细胞移植镇痛的耐受现象及宿主对阿片制剂的敏感性 ,以评估该方法的临床应用价值。方法　 36只雄性大鼠制作成单侧压迫性坐骨神经痛模型 ,随机分为两组 ,向蛛网膜下腔分别植入不同内容物。实验组 :10 μl嗜铬细胞悬液 ;对照组 :10 μl细胞培养液。连续观察 10周内大鼠患肢足趾部热痛阈的改变 ,并于移植术后第 6周 ,观察腹腔注射芬太尼 (0 0 2、0 2、2或2 0 μg)后动物最大抗热伤害效应的变化。 结果　坐骨神经结扎 5天后 ,该侧肢体表现出明显的痛敏现象 ,热痛阈显著降低 (P <0 0 1)。实验组细胞移植 1周后 ,动物的痛敏现象消失 ,热痛阈恢复至基础水平 ,并在其后的观察时间内无显著性改变 (P >0 0 5 )。而对照组动物在术后 9周内无明显改善 ,直至第 10周热痛阈才恢复至基础水平。腹腔注射 0 2 μg以上剂量的芬太尼 ,可明显提高两组动物的痛阈 ,增强其抗伤害效应。结论　蛛网膜下腔移植嗜铬细胞镇痛无耐受现象 ,且宿主对阿片制剂的敏感性增强 。Objective The tolerance phenomenon of intrathecal analgesia and host sensitivity to opoioid after subarachnoid transplantation with chromaffin cells were observed successively in order to evaluate the clinical prospect of this method for chronic pain management.Methods 36 male Sprague Dawley rats,weighted 180 220g,ligated unilateral sciatic nerve,were randomly allocated into two groups.The suspended chromaffin cells 10μl was injcected into subarachnoid space in group T(the experiment group),and 10μl cell culture medium in group C(the control group).The basal pain threshold to thermal stimuli was determined before nerve ligation.The analgesiometric tests were repeated once a week following the transplantations for 10 weeks.Sixth week after the implantation,rats were intraperitoneal injected with different dose of fentanyl(0 02,0 2,2 or 20μg) and then the changes of the rat′s greatest antinociceptive effects observed. Results Five days after being ligated unilateral sciatic nerve,rats back limbs of the same lateral were markedly sensitive to pain and the pain threshold to thermal stimuli reduced markedly.One week after the cell transplantation,pain sensitivity of the rats in group T was disappeared,pain threshold to thermal stimuli retrieved to the foundatin level and stabilized in the later time.But in group C,it was not significantly improved until 10th week.After intraperitoneal administration of fentanyl over 0 2μg,the greatest antinociceptive effects in the two groups were higher than those before injected( P< 0 05).Conclusions The tolerance phenomenon of intrathecal analgesia after subarachnoid transplantation with chromaffin cells is not observed and the host sensitivity to the opioid is more stronger.This method is suitable for management of chronic pain. [

关 键 词：慢性疼痛 嗜铬细胞 药物耐受 蛛网膜下腔 细胞移植 

分 类 号：R614[医药卫生—麻醉学]