促红细胞生成素对大鼠臂丛神经撕脱伤后脊髓神经元的保护作用及其机制  

Study on the neuroprotection and its molecular mechanisms of erythropoietin against brachial plexus root avulsion injury in rats

作　　者：李世杰[1] 高素洁[2] 李凯[2] Li Shijie;Gao Sujie;Li Kai(Deparment of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China;Department of Anesthesia, China-Japan Union Hospital of Jilin University, Changchun 130033, China)

机构地区：[1]吉林大学中日联谊医院甲状腺外科,长春130033 [2]吉林大学中日联谊医院麻醉科,长春130033

出　　处：《中华实验外科杂志》2019年第2期292-294,共3页Chinese Journal of Experimental Surgery

基　　金：吉林省发展与改革委员会项目 (2018C020).

摘　　要：目的 探讨间断皮下注射低剂量促红细胞生成素(EPO)对神经元的保护效果、不良反应及其机制。方法 将180只成年Wistar雄性大鼠随机等分为对照组(C组,根性撕脱+隔日皮下注射生理盐水1 ml)和促红细胞生成素组(EPO组,根性撕脱伤+隔日皮下注射EPO 1 000 U/kg)。两组分别在手术苏醒后即刻、1、2、4、7、14 d留取脊髓C5-T1段。尼氏体染色法观察神经元状态;原位缺口末端标记法(TUNEL)和裂解的聚腺苷二磷酸核糖聚合酶(c-PARP)检测神经元凋亡。结果 (1)两组损伤后7、14 d存活神经元急剧减少。组间比较,EPO组在第7天[(78.42±2.64)%]明显高于C组[(67.46±3.78)%],第14天[(57.32±4.07)%]明显高于C组[(46.42±3.14)%](P<0.05)。(2)两组神经元均有凋亡,组间比较,EPO组第4天TUNEL阳性A值(303.1±59.9)低于C组(861.6±85.4),在第7天(419.8±74.2)也显著低于C组(983.2±83.9)(P<0.05)。(3)脊髓神经元c-PARP情况,C组第4天达峰值,EPO组第7天达峰值。组间比较,EPO组在第2~4天显著低于C组(P<0.05)。(4)两组在血红蛋白量、红细胞数、血细胞压积,差异无统计学意义。结论 隔日皮下注射EPO 1 000 U/kg可增加臂丛神经根性撕脱伤后神经元存活,减少凋亡,且不影响血常规结果。Objective The neuroprotective and adverse effects, associated with low dosage erythropoietin (EPO) for the spinal cord neuron following nerve avulsion will be researched.Methods 180 Wistar rats were randomly divided into two groups: control group (avulsion + 1 ml normal saline s. c. on alternate days), EPO treated group (avulsion + 1 000 U/kg EPO s. c. on alternate days). The rats were sacrificed at day 0 (before avulsion), 1, 2, 4, 7 and 14 d after avulsion for harvesting C5-T1 spinal samples. We used Nissl, terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL), and Cleaved-poly adenosine diphosphate-ribose polymerase (c-PARP) stainings to analyze the survival and apoptotic neurons.Results (1) The percentage of survivial neurons was significantly decreased, EPO group has more survival neurons compared with C group at 7 d [(78.42±2.64)% and (67.46±3.78)%] and 14 d [(57.32±4.07)% and (46.42±3.14)%]. (2) TUNEL positive (apoptotic) neurons appeared at 2 d, followed by a gradual change until 14 d. The TUNEL in EPO group was significantly decreased at 4 d [(303.1±59.9) and (861.6±85.4)] and 7 d [(419.8±74.2) and (983.2±83.9)] compared to C group. (3) The c-PARP, which is a critical apoptotic factor, was showed a pronounced decrease in EPO group than control ones at 2 d and 4 d. (4)There are no significant differences on blood routine examination in two groups at all time points.Conclusion With administration of 1 000 U/kg EPO, the survival rate of neurons was enhanced and apoptosis was alleviated without significant erythropothesis effect.

关 键 词：臂丛神经根性撕脱伤 神经元 细胞凋亡 裂解的聚腺苷二磷酸核糖聚合酶 

分 类 号：R688[医药卫生—骨科学]