颈交感神经在臂丛神经慢性卡压伤中的作用  

The effect of cervical sympathetic nerve on chronically compressed brachial plexus

作　　者：吴可晚 陈琳[2] 杨剑云[2] 

机构地区：[1]宁波市鄞州第二医院急诊科,315100 [2]复旦大学附属华山医院手外科,上海

出　　处：《中华手外科杂志》2013年第5期301-304,共4页Chinese Journal of Hand Surgery

摘　　要：目的研究颈交感神经在臂丛神经慢性卡压伤中的作用。方法24只雄性sD大鼠，随机分成A、B、C三组，每组8只。A组：臂丛神经下干慢性卡压模型；B组：臂丛神经下干慢性卡压模型，加颈中交感神经节切除；C组：对照组。3个月后，各组进行神经电生理检测第一骨间肌复合肌肉动作电位（CMAP），记录其波幅和潜伏期；切取臂丛神经下干卡压远侧3min神经干和C组臂丛神经下干，行甲苯胺蓝染色，半薄横切片，计数有髓神经纤维；切取C8、Tl背根神经节，用RT-PCR方法检测背根节中P物质（SP）mRNA。结果神经电生理检测CMAP波幅：A组（2．2±1．1）mV，B组（3．9±1．1）mV，C组（8．6±2．0）mV；A组〈B组〈C组，差异有统计学意义（P〈0．01）。潜伏期：A组（4．8±0．9）ms，B组（3．9±0．5）rns，C组（2．8±0．2）ms；A组〉B组〉C组，差异有统计学意义（P〈0．01）。有髓神经纤维总数：A组（3583．0±540．0），B组（5098．0±742．0），C组（7934．0±868．0）；A组〈B组〈C组，差异有统计学意义（P〈0．01）。P物质mRNA表达水平：A组（3．6±0．8）×10-2，B组（2．2±0．7）×10-2，C组（1．2-±O．3）×10-2；A组〉B组〉C组，差异有统计学意义（P〈0．01）。结论在交感神经作用下，臂丛神经慢性卡压伤的损伤程度加重，背根神经节中疼痛介质P物质表达增强，去交感神经有利于减轻臂丛神经慢性卡压伤损伤程度，有利于减轻因卡压引起的疼痛。交感神经激惹可能是臂丛神经慢性卡压性疾病发展的一个协同因素。Objective To investigate the role of cervical sympathetic nerve in the development of chronic compression of the braehial plexus. Melhods Twenty-four male Sprague-Dawley rats were randomly divided into 3 groups with 8 rats per group. Lower tnmk chronic compression was created in rats of group A and group B. In addition, the middle cervical sympathetic ganglions were resected in rats of group B. Group C served as normal control. Three months after the compression surgery, compound muscle action potentials （CMAPs） of the first interossens were obtained to record CMAP latency and amplitude. A 3 mm long nerve segment of the distal part of the compressed lower tnmk was harvested and semi-thin sections were collected for toluidine blue staining. The number of myelinated nerve fibers was counted. The C8 and T1 dorsal root ganglia （DRG） were harvested to detect the mRNA expression level of substance P （SP） using RT-PCR. Results CMAP amplitude was （2.2± 1.1）mV, （3.9± 1.1）mV and （8.6± 2.0） mV in group A, B and C, respectively. The differences of the amplitudes among group A, B and C （group A 〈 group B 〈 group C） were significant （ P 〈 0.01）. CMAP latency was（4.8 ± 0.9）ms, （3.9 ± 0.5）ms and （2.8± 0.2）ms in group A, B and C, respectively, the differences （group A 〉 group B 〉 group C） also being statistically significant （P 〈 0.01 ）. The total number of myelinated nerve fibers （group A 〈 group B 〈 group C） was （3583 ± 540）, （5098 v 742）, （7934 ± 868）, respectively. The difference was significant （P 〈0.01）. The level of Sic） mRNA （group A〉 group B〉 group C） was （3.6 ± 0.8） × 10-2, （2.2 ± 0.7） × 10-2, （1.2± 0.3） × 10-2, respectively, being significantly different among the groups （ P 〈 0.01）. Conelttsion The existence of cervical sympathetic nerve can worsen the degree of brachial plexus lesion due to chronic compression. It causes increase in the expression of substance P in dorsal root ganglia. S

关 键 词：神经节 交感 臂丛 模型 动物 神经卡压 

分 类 号：R687.3[医药卫生—骨科学]