伽玛刀照射后兔三叉神经的病理组织学改变研究  

Experimental studies of gamma knife irradiation-induced pathological changes in the trigeminalnerves of rabbits

作　　者：程轶峰[1] 刘晓民[1] 徐德生[1] 宗永青[1] 戈有林[1] 

机构地区：[1]天津医科大学第二医院神经外科伽玛刀中心,天津300211

出　　处：《中华神经医学杂志》2016年第2期145-149,共5页Chinese Journal of Neuromedicine

基　　金：天津市卫生局科技基金（2014KZ100）

摘　　要：目的观察不同剂量伽玛刀照射实验兔三又神经根的病理组织学改变，探讨伽玛刀照射剂量与三叉神经放射损伤的关系。方法将15只新西兰兔按随机数字表法分为60Gy照射组、80Gy照射组、100Gy照射组、120Gy照射组及对照组，每组3只。前4组取相应中心剂量射线照射兔双侧三叉神经根，操作应用4mnl准直器，靶点设定于三叉神经桥脑进入区。照射后6个月取病理标本，行HE染色、髓鞘染色、免疫组化染色及透射电镜观察，且对髓鞘染色及免疫组化染色病理结果应用Image．proplus6．0图像处理系统进行吸光度值测定。结果60Gy照射组照射后其病理组织学改变与对照组比较无明显差异；80Gy照射组照射后出现部分神经纤维断裂、变性，脱髓鞘改变；100Gy照射组照射后神经损伤加重，部分神经出现坏死；120Gy照射组照射后绝大部分神经纤维溶解、消失、完全脱髓鞘，大部分神经坏死。统计学分析显示，60Gy照射组髓鞘染色和神经丝蛋白免疫组化染色吸光度值较对照组差异无统计学意义（P〉0．05），而80Gy照射组、100Gy照射组、120Gy照射组较对照组差异均有统计学意义（P〈0．05），且随照射剂量增加逐渐减少。结论伽玛刀照射剂量与三叉神经放射损伤的病理组织学改变密切相关，60Gy照射不会引起神经明显变化，100Gy、120Gy照射会导致神经坏死，80Gy照射更为安全有效。Objective To explore the relation of gamma knife radiation of different doses with trigeminal nerve radiation damage by investigating the pathologic changes of trigeminal nerve roots after different doses of gamma knife radiation. Methods Fifteen New Zealand rabbits were randomly divided into 60 Gy radiation group, 80 Gy radiation group, 100 Gy radiation group, 120 Gy radiation group and control group （n=3）. Bilateral trigeminal nerves of all New Zealand rabbits, excepted for the control group, were irradiated; and a 4-mm isocenter was placed at trigeminal nerver root entry zone. All New Zealand rabbits for pathological observation were sacrificed after six months. The roots were examined by light microscopy, immunohistochemistry, and electron microscopy. Integrated optical density of the myelin staining and immunohistochemistry staining results of the four groups were examined by Image-pro plus 6.0 image processing system, and analyzed using method of statistics. Results Pathological observation showed the result of 60 Gy group after irradiation did not differ significantly as compared with the result of control group; in 80 Gy group, there was part nerve fiber fragmentation and degeneration, and demyelination; in 100 Gy group, there was nerve fiber fragmentation, degeneration and demyelination, and part of nervous necrosis; in 120 Gy group, there was almost all nerve fiberdissolution, disappearance and demyelination, and most of nervous necrosis. The integrated optical density of the myelin staining and immunohistochemistry staining results of 60 Gy group did not differ significantly as compared with that of the control group （P〉0.05）; the results of 80Gy, 100 Gy and 120 Gy group differed significantly as compared with that of control group （P〈0.05） and decreased following the increase of irradiation doses. Conclusions The histopathological changes of the trigeminal nerve irradiated by gamma knife have significant correlation with irradiation doses. The result of 60 Gy group after irradiation do

关 键 词：伽玛刀 三叉神经 立体定向放射外科 病理组织学 

分 类 号：R745.11[医药卫生—神经病学与精神病学]