鞘内注射小剂量纳洛酮 吗啡混合芬太尼对大鼠后足切割痛觉和尾椎间盘炎症因子表达的影响  

Effects of foot cutting pain and expression of inflammatory factors in caudal disc

作　　者：王亚红 王新强[1] 汤建儿[1] Wang Yahong

机构地区：[1]浙江省湖州市第一人民医院,313000

出　　处：《浙江临床医学》2020年第3期315-318,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省公益研究计划项目(GF19H160014)。

摘　　要：目的探讨鞘内注射小剂量纳洛酮、吗啡混合芬太尼对切口痛模型大鼠痛觉行为和尾椎间盘炎症因子表达的影响.方法雄性SD大鼠40只,随机分为正常对照组(A组)、手术切口组(B组)、B组基础上小剂量纳洛酮、吗啡混合芬太尼组(C组)、B组基础上吗啡混合芬太尼组(D组).采用Brennan法制作足切割痛模型并给予小剂量纳洛酮、吗啡混合芬太尼鞘内注射.观察各组大鼠累计疼痛评分、尾椎间盘IL-6、IL-1β及TLR4/NF-κB信号通路[Toll样受体4(TLR-4)、髓样分化因子88(MyD88)、核因子κB(NF-κB)、肿瘤坏死因子-α(TNF-α)]的表达.结果与A组比较,B组尾椎间盘TLR-4、MyD88、NF-κB、TNF-α及IL-6、IL-1β表达增强(P<0.05).与B组比较,C组和D组大鼠尾椎间盘TLR-4、MyD88、NF-κB、TNF-α及IL-6、IL-1β表达降低(P<0.05),且C组大鼠尾椎间盘TLR-4、MyD88、NF-κB、TNF-α及IL-6、IL-1β表达显著低于D组(P<0.05).与A组比较,其余各组大鼠术后累积疼痛评分增加(P<0.05).与B组比较,C组和D组大鼠累积疼痛评分减少(P<0.05);且C组大鼠累积疼痛评分显著低于D组(P<0.05).结论鞘内注射小剂量纳洛酮、吗啡混合芬太尼对切口痛大鼠具有较好的镇痛效果,提示其镇痛机制可能是通过抑制炎症TLR4/NF-κB信号通路及炎症因子的表达而实现的.Objective To investigate the effects of intrathecal injecrion of low-dose naloxone and morphine-mixed fentanyl on pain behavior and expression of inflammatory factors in the intervertebral disc of rats with incisional pain.Methods 40 male Spragiie-Dawley rats were randomly divided into nomial control group(group A),surgical incision group(group B),low-dose naloxone,morphine-mixed fentanyl group(group C)and morphine mixed fentanyl group(group D).A foot pain model was made using the Brennan method and a small dose of naloxone,morphine,and fentanyl were injected intrathecally.The cumulative pain score,the levels of IL-6,IL-1β and TLR4/NF-κB signaling pathways[Toll-like receptor 4(TLR-4),myeloid differentiation factor 88(MyD88),nuclear factor κB(NF-κB)and tumor necrosis factor-α(TNF-α)1 in tail intervertebral disc were observed in each group.Results Compared with group A,the expressions of TLR-4,MyD88,NF-κB,TNF-α,IL-6 and IL-1β in the intervertebral disc was enhanced(P<0.05).Compared with group B,the expression of TLR-4,MyD88,NF-κB,TNF-α,IL-6 and IL-1 P in tail intervertebral discs of group C and group D decreased(P<0.05),and the expressions of TLR-4,MyD88,NF-κB,TNF-α,IL-6 and IL-1 P in the intervertebral disc were significantly lower than those in the D group(P<0.05).Compared with group A,the cumulative pain scores of the other groups were increased(P<0.05).Compared with group B,the cumulative pain scores of rats in group C and group D were decreased(P<0.05);and the cumulative pain scores in group C were significantly lower than those in group D(P<0.05).Conclusion Intrathecal injecrion of low-dose naloxone and morphine mixed with fentanyl has a good analgesic effect on rats with incisional pain,suggesting that the analgesic mechanism may be through inhibition of inflammatory TLR4/NF-κB signaling pathway and inflammatory factors.

关 键 词：鞘内注射 纳洛酮 切口痛大鼠模型 尾椎间盘 炎症因子 

分 类 号：R61[医药卫生—外科学]