大鼠坐骨神经延长术对疼痛影响的实验研究  

Experimental study of the effect of the sciatic nerve elongation on pain in rats

作　　者：李星玮[1] 莎茹拉[1] 鲍丙波 高涛 林俊卿 郑宪友[1] LI Xingwei;SHA Rula;BAO Bingbo;GAO Tao;LIN Junqing;ZHENG Xianyou(Department of Orthopedics,Shanghai Jiao Tong University Affiliated Sixth People's Hospital,Shanghai,200233,P.R.China)

机构地区：[1]上海交通大学附属第六人民医院骨科

出　　处：《中国修复重建外科杂志》2019年第7期894-900,共7页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(81672144);上海市教育委员会高峰高原学科建设计划(20161429)~~

摘　　要：目的探讨大鼠坐骨神经延长术对疼痛的影响。方法SPF级成年雄性Wistar大鼠36只,体质量250~300 g。取其中18只大鼠随机分为3组,每组6只,分别为坐骨神经延长组(A组)、单纯外支架固定非延长组(B组)、神经切断结扎组(C组)。3组均建立10 mm长坐骨神经缺损模型,A组在外支架固定基础上以1 mm/d速度进行坐骨神经延长,共延长14 d;B组单纯行外支架固定;C组直接结扎断端神经。术后3、7、10、14 d采用自伤行为评分量表评价大鼠足部损伤情况;术后14 d取各组大鼠L4~S1脊髓背根神经节(dorsal root ganglia,DRG),行TNF-α免疫组织化学染色观察,用纯血清代替一抗处理标本作为阴性对照组。另取18只大鼠随机分为3组,每组6只,分别为坐骨神经延长组(A1组),单纯外支架固定非延长组(B1组)、阳性对照组(C1组),每组6只。A1、B1组同A、B组方法建立10 mm长坐骨神经缺损模型后进行外支架固定,术后3 d无麻醉状态下作或不作神经延长;C1组不作造模处理,于足趾部注射20μL 2.5%甲醛。90 min后取大鼠L4~S1节段脊髓后角行即早基因c-Fos免疫组织化学染色观察,并计数阳性细胞数,使用纯血清代替一抗处理标本作为阴性对照组。结果术后延长过程中B、C组大鼠自伤行为评分均逐渐增加,A组较稳定维持在(0.25±0.50)分。术后各时间点C组评分均显著高于A、B组,术后10、14 d时A组评分显著低于B组,差异均有统计学意义(P<0.05)。TNF-α免疫组织化学染色示,A组TNF-α表达微弱,呈轻微阳性(+/-);B组TNF-α呈阳性表达(+);C组呈强阳性表达(++);阴性对照组DRG无TNF-α表达(-)。c-Fos免疫组织化学染色示,A1、B1组呈弱阳性表达,C1组呈明显强阳性表达,阴性对照组无c-Fos阳性表达。A1、B1、C1组和阴性对照组c-Fos阳性细胞数分别为(21.5±6.6)、(19.3±8.1)、(95.6±7.4)和0个/视野,C1组显著高于A1、B1组(P<0.05),A1、B1组间比较差异无统计学意义(P>0.05)。结论大�Objective To investigate the effect of the sciatic nerve elongation on pain in rats. Methods Thirtysix adult male Wistar rats of SPF grade, weighing 250-300 g. Eighteen of them were randomly divided into 3 groups, 6 rats in each group. They were sciatic nerve elongation group(group A), nerve no-elongation group(group B), and nerve ligation group(group C). The model of 10-mm sciatic nerve defect was established in all 3 groups. The sciatic nerve was extended at a speed of 1 mm/d for 14 days in group A. The group B was only installed with external fixation. The nerve stumps were ligated in the group C. At 3, 7, 10, and 14 days after operation, the foot injury was evaluated by the autotomy scoring scale. At 14 days after operation, the dorsal root ganglia(DRG) of L4-S1 spinal cord of rats in each group was observed by tumor necrosis factor α(TNF-α) immunohistochemical staining, and the primary antibodies were replaced by pure serum as negative control group. Another 18 rats were randomly divided into 3 groups, 6 rats in each group. They were sciatic nerve elongation group(group A1), nerve no-elongation group(group B1), positive control group(group C1).In groups A1 and B1, the 10-mm long sciatic nerve defect model was established by the same method as groups A and B,and then fixed with external fixation. Nerve elongation was done or not done without anesthesia at 3 days after operation.In group C1, no modeling was done and 20 μL 2.5% formaldehyde was injected into the toes. After 90 minutes, the dorsal horn of spinal cord of L4-S1 segment of rats was cutting for c-Fos immunohistochemical staining and the number of positive cells was counted. Primary antibodies were replaced with pure serum as negative control group. Results The autotomy scores of rats in groups B and C gradually increased postoperatively, and group A remained stable at 0.25±0.50.The scores of group C were significantly higher than those of group A and group B at each time point postoperatively(P<0.05). The scores of group A were significantly low

关 键 词：周围神经缺损 神经延长 自伤行为 疼痛 大鼠 

分 类 号：R651.3[医药卫生—外科学]