海水浸泡对大鼠坐骨神经损伤后促炎因子表达的影响及早期干预效果观察  

Influence of seawater immersion on expression of proinflammatory cytokines and intervention effect of methylprednisolone for sciatic nerve injury in rats

作　　者：王海峰[1] 丁宏霞 胡沣 洪鹤[1] 李葛巍 符来想[1] 方健 

机构地区：[1]解放军第105医院(安徽医科大学解放军临床学院)显微骨四科,合肥230031

出　　处：《解放军医学杂志》2015年第10期788-793,共6页Medical Journal of Chinese People's Liberation Army

基　　金：南京军区"十一五"医学科研重点课题(09Z008)~~

摘　　要：目的探讨海水浸泡加重坐骨神经损伤的机制和甲泼尼龙的保护作用,为海水浸泡坐骨神经损伤的临床治疗提供实验依据。方法健康雄性清洁级SD大鼠192只,随机分为假手术组(A组)、损伤对照组(B组)、损伤+海水浸泡组(C组)、甲泼尼龙治疗组(D组),每组48只。B、C、D组制作大鼠坐骨神经钳夹伤模型,C、D组制模成功后浸入人工海水1h,D组伤后给予甲泼尼龙20mg/(kg·d)尾静脉注射(共2d)。分别于伤后3d及1、2、4周采用坐骨神经功能指数(SFI)评定神经运动功能,然后取大鼠坐骨神经组织,采用RT-PCR检测IL-1β、IL-6和TNF-αm RNA表达水平,免疫组织化学法检测IL-1β、IL-6和TNF-α蛋白表达情况。结果伤后3d及1、2、4周A组坐骨神经功能指数无明显变化,而B、C、D组坐骨神经功能指数逐渐升高,且B、D组明显高于C组,差异有统计学意义(P<0.05)。伤后3d及1、2、4周A组坐骨神经组织中IL-1β、IL-6、TNF-αm RNA表达水平均较低,而B、C、D组IL-1β、IL-6 m RNA表达水平逐渐下降,且伤后3d及1、2周时B、D组表达水平明显低于C组(P<0.05),伤后4周时3组间比较差异无统计学意义(P>0.05);B、C、D组TNF-αm RNA表达水平在伤后3d及1、2周时逐渐下降,且伤后3d及1周时B、D组表达水平明显低于C组(P<0.05),伤后2周及4周时3组间比较差异无统计学意义(P>0.05)。伤后3d及1、2、4周A组坐骨神经组织中IL-1β、IL-6、TNF-α蛋白均呈阴性(–)或弱阳性(+)表达,B、C、D组在伤后3d及1周时呈强阳性(++)表达,此后逐渐减弱,至伤后4周时均呈阴性(–)或弱阳性(+)表达。结论海水浸泡增加了损伤的坐骨神经组织中IL-1β、IL-6和TNF-α的表达,导致炎症反应加重,阻碍了神经功能恢复。甲泼尼龙可促进海水浸泡大鼠坐骨神经的再生,其机制可能与抑制炎性反应有关。Objective To explore the mechanism of aggravation of sciatic nerve injury after seawater immersion and the protective effect of methylprednisolone against injury so as to provide an experimental basis for clinical treatment of seawater immersion complicated sciatic nerve injury. Methods A total of 192 Sprague-Dawley rats were randomly divided into group A （sham injury group）, group B （injury control group）, group C （seawater immersion ＋ injury group）, group D （methylprednisolone treatment group）. The model of rat sciatic nerve injury was reproduced by crush injury in groups B, C and D. The sciatic nerves were crushed followed by seawater immersion for 1 hour in groups C and D. Methylprednisolone （20mg/（kg·d）） was injected ,ia the tail vein in group D for 2 days. The Sciatic Functional Index （SFI） was used to assess the nerve function on 3rd day and 1, 2 and 4 weeks after injury, and IL-1 β, IL-6, TNF-et mRNA and protein expression were determined with RT-PCR or immunohistochemistry. Results The SFI of group A showed no significant change on 3rd day up to 4 weeks after injury. The SFIs in groups B, C and D were gradually increased from 3rd day to 4 weeks after injury. SFI was lower in group C compared with groups B and D （P〈0.05）. The expressions of IL-l[3, IL-6 and TNF-α mRNA in group A were lower on 3rd day and 1, 2 and 4 weeks after injury. The expressions of IL-lβ and IL-6 mRNA in groups B, C and D were gradually decreased from 3 days to 4 weeks after injury, and the expression in group C was significantly higher than that of groups B and D on 3rd day and 1 and 2 weeks （P〈0.05）. No statistical difference was found in the 4th week among groups B, C and D. The expressions of TNF-α mRNA in groups B, C and D were gradually decreased from 3 days to 2 weeks after injury. The expression of TNF-α mRNA in group C was significantly higher than that of groups B and D on the 3rd day and 1st week （P〈0.05）. No statistical significant difference was found among groups B,

关 键 词：海水浸泡 坐骨神经损伤 甲泼尼龙 

分 类 号：R651.3[医药卫生—外科学]