C_4神经转位修复臂丛神经撕脱伤后C_4节段脊髓组织中ChAT表达变化的研究  

ChAT change in C_4 spinal cord tissue after C_4 cervical plexus transposition for repairing brachial plexus avulsion

作　　者：彭林[1] 邹林[2] 蔡锦方[2] 刘立峰[2] 

机构地区：[1]辽宁医学院,辽宁锦州121001 [2]济南军区总医院

出　　处：《山东医药》2012年第26期31-33,共3页Shandong Medical Journal

基　　金：全军医药卫生科研基金资助项目(06M098)

摘　　要：目的观察臂丛神经撕脱伤模型C4转位修复治疗后C4节段脊髓组织中乙酰胆碱转移酶(ChAT)的变化。方法 Wistar大鼠30只,随机分为A、B、C组,各10只。A、B组建立臂丛神经撕脱伤模型。建模后,A组为实验组,行C4转位修复治疗;B为对照组,于椎间孔处切断C4和C6神经根后,不予吻合;C组为正常组,不进行手术。观察治疗后三组动物患肢功能;于术后3个月时,A组取C4、C6吻合口处神经0.5 cm,B组取C6断端0.5 cm神经,C组取C6神经根0.5 cm,均行HE染色,观察各组神经纤维情况;同时取三组动物C4段脊髓组织,采用免疫组化ABC法行ChAT染色,计数脊髓前角ChAT阳性运动神经元。结果①治疗后A组动物右侧前肢屈曲活动基本正常,肱二头肌未见萎缩;B组动物右侧前肢屈曲不能,呈伸直畸形,肱二头肌肌腹萎缩;C组动物正常。②HE染色后,A组可见多处再生神经纤维及髓鞘,分布均匀、致密,外膜连续,神经纤维排列较整齐;B组可见散在稀少神经纤维,排列紊乱无序,并有多处异物体形成;C组神经纤维分布均匀、致密,排列整齐。③A、B、C组C4脊髓前角ChAT免疫阳性运动神经元数分别为(23.27±3.35)(、19.53±2.97)(、25.53±3.42)个,A、C组与B组比较,P均<0.05,A组与C组相近(P>0.05)。结论臂丛神经根性撕脱伤模型C4转位修复治疗后C4节段脊髓组织中ChAT表达上调,这可能是C4转位修复治疗臂丛神经根性撕脱伤疗效好的原因之一。Objective To observe after ChAT changes in C4 spinal cord tissue C4 transposition to repair brachial plexus avulsion in rats. Methods 30 Wistar rats were randomly divided into group A,B and C, 10 each group. Group A and B were established a brachial plexus avulsion model. Group A was the experimental group, Ca transposition were anderwent for repairing braehial plexus avulsion; group B was control group, C4 and C6 nerve root was cut and no anastomosis at the intervertebral foramen ; group C was normal control group, without operation. After 3 months, the nerve 0.5 cm was got between C4 and C6 anastomotic in group A, 0.5 cm in the stump of C6 in group B and 0.5 cm in C6 in group C were stained with HE and then observed; at the same time, C4 spinal cord tissues were stained by immunohistochemical ABC method, the number of ChAT spinal anterior horn motor neuron immunoreaetive positive neurons was calculated. Results ①Rigbt forelimb flexion of group A was normal, triceps brachii-two was no atrophy ; right forelimb flexion of group B animal was not a straight, deformity, and triceps brachii-two belly of the muscle was atrophy ; group C was normal. ②Afler HE staining, there was a lot of regenerating nerve fibers and myelin, uniform, dense, epicardial continuous in group A, and nerve fiber was arranged neatly; there were small nerve fibers which was disordered and many foreign objects in group B; the nerve fiber is uniform, dense, neat in group C. ③The ChAT immunoreactive motoneurons numbers of C4 spinal cord anterior horn of group A, B and C were 23.27 ± 3.35, 19.53 ± 2.97, 25, 53 ± 3.42, respectively. That were different in group A, C compared with group B （ all P 〈 0.05 ）, and group A was similar to group C （ P 〉 0. 05 ）. Conclusions After C4 transfering for repairing brachial plexus, ChAT expression in C4 spinal cord tissue is up, which may be one of the reasons that C4 transposition has good effect for repairing braehial plexus root avulsion.

关 键 词：神经损伤 臂丛撕脱伤 颈丛转位疗法 乙酰胆碱转移酶 

分 类 号：R651.3[医药卫生—外科学]