Arnold-Chiari畸型合并脊髓空洞发病机理实验研究  

Experimental study on pathogenesis of syringomyelia associated with Arnold Chiari malformation

作　　者：郭俭[1] 黄红云[2] 刘宗惠[2] 周正谋[2] 罗毅[3] 关运鹏 崔月汉[2] 申存瑛 冯涛[2] 

机构地区：[1]海军401医院神经外科,青岛266071 [2]海军总医院 [3]解放军总医院

出　　处：《中华神经外科杂志》1999年第3期173-176,共4页Chinese Journal of Neurosurgery

摘　　要：目的　建立ＡＣＭ－ ＳＭ 狗动物模型， 并探讨其发病机理。方法　８ 只健康家犬分两组进行梗阻前后压力测定并研究其变化趋势。模型组动物寰枕间隙置入梗阻物； 观察所有实验动物的行为改变； 不同时间行颅底及颈胸段脊髓ＭＲＩ检查； 对模型组动物进行病理学观察。显著性检验采用ｔ检验， 以Ｐ＜ ０－０５ 为显著差异。结果　８ 只动物梗阻前枕大池及脊髓蛛网膜下腔压力差的均数为０－０７５ ±０－０７１ （ Ｐ＞０－０５） 无显著差异。梗阻前后压力差比较Ｐ＜ ０－０１ 差异非常显著。梗阻后即刻与梗阻后３０ 分钟比较Ｐ＞０－０５， 无显著差异； 梗阻后３０ 分钟与梗阻６０ 分钟，Ｐ＜０－０５ 有显著差异； 梗阻即刻与梗阻６０ 分钟，Ｐ＜ ０－０２ 差异较显著。术后６ 只模型组动物均有行为异常。影像学检查， ６ 只模型组动物５ 只有脊髓空洞形成。组织学观察与人类空洞及脑积水周围结构一致。结论　枕大孔处蛛网膜下腔梗阻， 导致枕大池压力升高， 使Ⅳ脑室ＣＳＦ冲开中央管上口进入中央管， 反复冲击中央管，并向外膨胀破坏室管膜进入脊髓实质，Objective To establish a kind of animal model of ACM with SM and research it's pathogensis.Methods (1) Eight dogs were divided into two groups: A: control group; B: model group. The pressures of cisternal and spinal subarachnoid spaces (SSAS) on 8 dogs were measured before and after obstruction, it's pathologic change was also studied. A wedge shape of rubber substance was put between suboccipito atlantal space to make a crowed foramen magnum. (2) The action of 8 dogs were observed. (3) Skull base and cervical thoracic spine were examined with MRI at various time. (4) Histologic changes were also observed.Results The means pressure difference between cisternal and SSAS before obstruction was 0 075±0 071mmHg (P>0 05). At different time after obstruction, between 0 minute and 30 minutes,P>0 05, 30 minutes and 60 minutes, P<0 05. 0 minute and 60 minutes, P<0 02, After obstruction, all aminals in model group showed abnomal behaviour. MRI studies demonstrated that 5 of 6 animals revealed syrinx. Histologic changes were similar to syrnix and hydrocephalus in human.Conclusion The obstruction of SSAS at foramen magnum leads to cisternal pressure increasing, and then forces CSF into the spinal central canal. The distended canal may destroied enpendyma, which could lead the formation of multiple communicating cavities in the spinal cord.

关 键 词：A-C畸形 脊髓空洞 发病机理 动物模型 

分 类 号：R744.02[医药卫生—神经病学与精神病学] R744.402[医药卫生—临床医学]