脉冲射频及连续射频对大鼠坐骨神经超微结构的影响观察  

Observation of Effects of Pulsed Radiofrequency and Conventional Radiofrequency on the Ultrastructural of Sciatic Nerve in Rats

作　　者：师存伟[1] 敬晓鹏[1] 刘咏梅[2] 冶占福[1] 宋涛[3] 

机构地区：[1]青海大学附属医院疼痛科,西宁810001 [2]沈阳市一五七医院内科,沈阳110045 [3]中国医科大学附属第一医院疼痛科,沈阳110001

出　　处：《中国医科大学学报》2013年第9期769-772,共4页Journal of China Medical University

基　　金：国家自然科学基金(81271371)

摘　　要：目的观察比较脉冲射频(PRF)及连续射频(CRF)处理大鼠坐骨神经后的超微结构改变。方法 50只大鼠被随机分为5组,每组10只。对照组只暴露分离坐骨神经不做任何处理;假实验组插入电极但不通电流;PRF-42℃组,给予脉冲射频处理,温度42℃;CRF-42℃组,给予连续射频处理,温度42℃;CRF-70℃组,给予连续射频处理,温度70℃。观察不同处理组神经纤维超微结构的改变,并比较神经病变的分级。结果所有处理组中的无髓鞘轴突均表现为正常的超微结构,PRF-42℃组大部分轴突仅表现为磷脂脱落,未发现存在严重变性的髓鞘轴突,也可发现新形成的髓鞘轴突。CRF-42℃组约1/3的髓鞘轴突可以观察到严重的变性。而CRF-70℃组多数髓鞘轴突可以观察到严重的变性。变性表现为髓鞘崩解、形成髓鞘球,细胞骨架成絮状或消失,线粒体膨胀或消失。PRF-42℃组展示较好的分级情况,而CRF-70℃组分级情况最差,组间比较有统计学差异(P<0.05)。结论脉冲射频可以造成可逆的磷脂脱落,而连续射频尤其是高温射频(70℃)对神经结构造成严重的不可逆性损伤,提示两种模式的治疗机制不同。Objective To observe and compare the ultrastructure changes of sciatic nerve tissue that was treated by PRF and CRF.Methods A total of 50 rats were divided into five groups （10 rats per group）randomly.The sciatic nerve in the control group was only exposed without any treatment; in sham group,the electrode was placed within the sciatic nerve but no current was passed through the electrode;in PRF-42℃ group,the rats was given pulsed radiofrequency treatment at the temperature of 42 ℃ ; in CRF-42 ℃ group,the tats was given the continuous radio frequency treatment at the temperature of 42 ℃;in CRF-70 ℃ group,the rats was given continuous radio frequency treatment at the temperature of 70 ℃.The ultrastructural changes and the classification of neuropathy were observed in different groups.Results The unmyelinated axons were found to be normal ultrastructuralin all the groups.In PRF-42 ℃ group,the myelin loss was found in the most of the damaged myelinated axons,but no severe degeneration of myelinated axons.Newly formed myelinated axons were also observed in this group.In CRF-42 ℃ group,nearly one third of the myelinated axons showed severe degeneration findings.In CRF-70 ℃ group,severe degeneration were found in many of the myelinated axons.In these axons,myelin collapsed to form ovoids,the cytoskeleton was floccular or absent,and the mitochondria were swollen or absent.The results of ultrastructural grades of myelinated axons indicated that PRF groups had better grades,while the group of treated with CRF with 70 ℃ showed the worst grade.The difference between the two groups was statistically significant （P ＜ 0.05）.Conclusion Pulsed radiofrequency can cause reversible myelin loss while the continuous radiofrequency,especially the high temperature （70 ℃） of the radiofrequency will cause irreversible myelin loss,which indicate that the treatment mechanisms are different in the two modes.

关 键 词：脉冲射频 连续射频 超微结构 电子显微镜 

分 类 号：R361.3[医药卫生—病理学]