脉冲射频对CCI大鼠坐骨神经组织学及脊髓GDNF表达的影响  

EFFECTS OF PULSED RADIOFREQUENCY ON HISTOLOGICAL CHANGE OF SCIATIC NERVE AND GDNF EXPRESSION IN SPINAL CORD OF CCI RATS

作　　者：贾子普 任浩[1] 李倩[1] 罗芳[1] 

机构地区：[1]首都医科大学附属北京天坛医院疼痛中心,北京100050

出　　处：《中国疼痛医学杂志》2016年第5期342-348,共7页Chinese Journal of Pain Medicine

基　　金：北京市卫生系统高层次人才(学科骨干)项目(No.2014-3-035)

摘　　要：目的：观察脉冲射频（pulsed radiofrequency,PRF）作用于慢性坐骨神经缩窄模型（chronic constriction injury,CCI）大鼠神经干结扎部位后大鼠疼痛行为学、坐骨神经组织学变化,检测脊髓L4~6节段胶质细胞源性神经营养因子（glial cell-derived neurotrophic factor,GDNF）表达变化。方法：36只SD大鼠随机等分为3组：Sham-Sham（SS）、CCI-Sham（CS）、CCI-PRF（CP）。结扎CS、CP组大鼠右侧坐骨神经干,制作CCI模型;SS组仅分离坐骨神经不结扎。术后第14天,将PRF作用于CP组大鼠坐骨神经干结扎处;SS、CS组仅放置电极针不通电。不同时间点观察3组大鼠的疼痛行为学变化。治疗后14天酶联免疫吸附法检测大鼠脊髓L4~6节段GDNF表达水平,光镜下观察大鼠坐骨神经组织学变化。结果：造模后CS、CP组大鼠结扎侧机械、热痛阈均较SS组明显降低,PRF治疗后14天CP组大鼠痛阈较CS组明显升高;光镜下CP组较CS组神经轴索数量、轴索直径、髓鞘厚度明显增加;CP组大鼠与CS、SS组大鼠相比较L4~6节段脊髓中GDNF表达明显升高。结论：PRF可能通过上调脊髓中GDNF的表达促进受损神经的修复,缓解CCI大鼠的神经病理性疼痛。Objective： To observe changes in pain behavior and the histology of the sciatic nerve（SN） after pulsed radiofrequency（PRF） at the ligation site of the SN in a chronic constriction injury（CCI） rat model and to investigate the effect of PRF on the expression of glia cell line-derived neurotrophic factor（GDNF） in the spinal cord. Methods： Thirty-six adult SD rats were randomly divided into 3 groups： Sham-Sham（SS）, CCI-Sham（CS） and CCI-PRF（CP）. The right SNs of the rats in the CS and CP groups were ligated to create a CCI model. For the SS group, the right SN was separated without ligation. On the day 14 after surgery, PRF treatment was applied at the ligation site of the SN in the CP group. The electrode was placed in the SS and CS groups without electricity applied. The hindpaw withdrawal threshold（HWT） and thermal withdrawal latency（TWL） were measured at various time points before and after the treatments in each group. Optical microscopic observation were given to the ligation sites of SNs of the rats in each group, and the GDNF expression levels in the L4~6 spinal cord segments were determined by enzymelinked immunosorbent assay（ELISA） 14 days after PRF/Sham treatment. Results： IN CCI rats, both HWT and TWL values in CS and CP groups decreased significantly compared to those in SS group（P〈0.01）. Fourteen days after PRF treatment, HWT and TWL values in CP group were significantly increased compared to those in CS group（P〈0.01）. The number, diameter and myelin sheath thickness of the nerve fiber at the SN ligation site significantly increased in CP group compared to those in CS group under optical microscope. The GDNF expression level at the L4~6 spinal segments in CP group was the highest among the 3 groups. Conclusions： Application of PRF at the impaired SN partially relieved the CCIinduced neuropathic painand repaired the lesions in the injured SN, possibly through upregulating the GDNF expression in the spinal cord.

关 键 词：脉冲射频 神经病理性疼痛 疼痛行为学 光镜 ELISA GDNF 

分 类 号：R741[医药卫生—神经病学与精神病学]