甲基强的松龙对兔脊髓空洞前状态神经细胞损伤的作用  

The protective effect of methylprednisolone on nerve cells at presyrinx state in rabbits

作　　者：孙国柱[1] 扈琳[2] 王荣英[2] 张庆俊[3] 

机构地区：[1]河北医科大学第二医院神经外科,石家庄市050000 [2]河北医科大学第二医院急诊科,石家庄市050000 [3]北京大学人民医院神经外科,北京市100044

出　　处：《中国脊柱脊髓杂志》2007年第11期865-868,I0003-I0004,共6页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨甲基强的松龙(MP)对实验性脊髓空洞前状态神经细胞损伤的作用。方法:新西兰兔112只,随机分为对照组和MP干预组,每组56只,枕大池穿刺注入Kaolin制作脊髓空洞模型,其中MP干预组术后予以大剂量MP干预(第1～3天每天30mg/kg耳缘静脉缓慢注射,第4～7天改为每天10mg/kg),对照组术后不给药。术后1d、3d、7d、2周、3周、6周、9周行神经功能评分(Tarlov评分),并分别于相应时间点处死8只动物取材,应用光镜、电镜以及原位末端标记法(TUNEL法)对所取上颈髓标本分别行病理形态学、超微结构及神经细胞凋亡检查。结果:与对照组比较,MP干预组动物3d后Tarlov评分明显较高(P<0.05),上颈髓水肿程度较轻,高峰延迟,3d后脊髓含水量显著降低(P<0.05),同时神经细胞凋亡率显著下降(P<0.05)。空洞形成率MP干预组为37.5%,对照组为87.5%,两组比较存在显著性差异(P<0.05)。结论:应用甲基强的松龙干预对脊髓空洞前状态神经细胞损伤有明显的保护作用,有助于减少脊髓空洞形成。Objective：To investigate the neuroprotective effect of methylprednisolone（MP） on nerve cells at presyrinx state.Method： 112 Newland rabbits were randomly divided into two groups evenly：Control group and MP group.After the experimental models of rabbits were established by intra-cisternal injection of kaolin, high-dose methylprednisolone （30mg/kg） was administered in animals in MP group,while animals in control group received nothing.Tarlov＇s motor scales were performed on all animals,then eight animals were sacreficed at 1d,3d,Td,2w,3w,6w,9w after operation,and the pathological and uhrastructural changes and apoptosis of upper cervical cord at each timepoint were sequentially studied by light and electronic microscopy and terminal deoxynucleotidyl transferase-mediated dUTP nick end lebeling （TUNEL） method.Result：Compared with animals of Control group,the animals in MP group received higher Tarlov＇s score after 3 days,the pathological changes and water content of upper cervical cord were significantly improved and spinal cord edemous peak was postponed to the 14th day in those of MP group（P〈0.05）.The number of apoptotic neuron cells in upper cervical cord decreased obviously,among which the apoptotic cells at the 7th day（14.21%±3.72%） and 14th day （9.79%±2.31%） were significantly lower,even cut down more than 60%.Especially what was worth mentioning was that the rate of syringomyelia decreased to 37.5% in the MP group compared with 87.5% in control group,with the decreasing width reaching to 50%.Statistics results showed that there was significant deviation between two groups（P〈0.05）.Conclusion：There is a neuroprotective effect of methylprednisolone on neuron cells at presyrinx state in rabbits,which is helpful to inhibit the syrinx formation.

关 键 词：甲基强的松龙 脊髓空洞前状态 凋亡 组织学 

分 类 号：R744.4[医药卫生—神经病学与精神病学] R977.1[医药卫生—临床医学]