实验性变态反应性神经炎周围神经轴膜离子通道的分布和作用  

DISTRIBUTION AND EFFECTS OF PERIPHERAL NERVE AXOLEMMA ION CHANNELS IN EXPERIMENTAL ALLERGIC NEURITIS

作　　者：李建萍[1] 吕传真[1] 

机构地区：[1]复旦大学医学院附属华山医院神经内科,上海200040

出　　处：《解剖学报》2008年第5期649-655,共7页Acta Anatomica Sinica

摘　　要：目的了解急性炎性脱髓鞘大鼠模型周围神经轴膜离子通道的变化及其对神经功能的影响。方法使用实验性变态反应性神经炎（EAN）大鼠模型，观察周围神经钠、钾离子通道在病程中的变化，结合神经组织学、神经电生理和临床症状，分析轴膜离子通道与神经传导功能的关系。结果轴膜离子通道在免疫后第9d EAN发病时即明显减少，此后2周内迅速消失。随之是缓慢的恢复过程，但直至免疫后85d，临床症状消失后数周仍未恢复至正常水平。病程中钠、钾通道的变化基本一致，且与结旁段髓鞘的变化密切相关。电生理指标在急性期（免疫后9~23d）与神经结构损害保持一致，动作电位波幅部分反应了轴膜离子通道的水平。结论轴膜离子通道异常是导致疾病起始阶段临床症状的直接原因之一，是病变过程中较易受损且较难恢复的结构部件，其在周围神经的准确定位和维护与特定的结旁段髓鞘结构紧密关联。Objective To reveal the distribution and effects of peripheral nerve axolemma ion channels in experimental allergic neuritis （EAN）. Methods The alteration of Na^＋ and K^ ＋ channels on peripheral nerves （PNs） in the course of EAN was observed and the relationship between the channels and nerve conduction properties was analyzed by assessing histology and electrophysiology of PNs as well as clinical severity. Results Na^＋ and K^＋ channels obviously decreased on day 9 post immunization （p.i.）, a time point of disease onset, and quickly became undetectable in next two weeks. Undergoing a slow and incomplete regeneration, neither of the channels regained the normal appearance on day 85 p.i. even if the clinical symptom disappeared several weeks before. Na^＋ and K^＋ channels had a synchronous development during disease course and remained a close correlation with the alteration of paranodal myelin. Electrophysiological abnormality kept consistent with the disturbance of PNs just in the acute period of EAN （9-23d p.i. ） and the compound muscle action potential （CMAP） amplitude partly reflected the distribution of axolemma ion channels. Conclusion Loss of axolemma ion channels of PNs might be one of the reasons directly leading to the early symptoms of EAN. As a structural component, the channels were liable to damage and difficult to restore. The clustering and maintenance of the channels were closely related with the specialized paranodal myelin.

关 键 词：变态反应 神经炎 单纤维 轴膜离子通道 髓鞘 免疫组织化学 电生理 大鼠 

分 类 号：R745.4[医药卫生—神经病学与精神病学]