靶肌肉注射胶质细胞源性神经营养因子对面神经损伤修复的作用  

Effects of target intramuscular injection of glial cell-derivedneurotrophic factor on the repair of crushed facial nerve injury

作　　者：倪萍 费静 肖阳 段坤岭 宋雪城 廖娜 李雷激 NI Ping;FEI Jing;XIAO Yang;DUAN Kunling;SONG Xuecheng;LIAO Na;LI Leiji(Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院耳鼻咽喉头颈外科,四川泸州646000

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第1期77-83,共7页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：泸州市科技计划项目(2021-SYF-30)。

摘　　要：目的 通过靶肌肉注射胶质细胞源性神经营养因子(GDNF),观察其对面神经压榨损伤后大鼠功能恢复、神经形态学及GDNF在中枢面神经元中表达的影响,探讨经靶肌肉注射GDNF治疗周围性面瘫的可行性及作用机理。方法 SD大鼠随机分为假手术组(只暴露右侧面神经主干)、模型组(面神经主干压榨)、实验对照组(面神经主干压榨+颊肌注射生理盐水)和实验组(面神经主干压榨+颊肌注射GDNF),通过颊肌电生理、面瘫症状评分观察大鼠的神经功能恢复,Masson染色观察颊肌纤维形态学变化、甲苯胺蓝染色观察面神经形态学变化、Western Blot检测面神经元中GDNF的表达。结果 (1)大鼠面瘫症状评分:假手术组无面瘫表现,评分为0分,造模后各组大鼠均出现周围性面瘫表现,评分均为5分;术后第28天,实验组大鼠面瘫症状已基本完全恢复,模型组及实验对照组较前有不同程度改善但未完全恢复,评分均>3分;(2)颊肌电生理:各组造模后与假手术组相比,峰潜伏期有不同程度延长、最大振幅有不同程度下降;随时间的推移,实验组峰潜伏期较模型组及实验对照组明显缩短(P<0.05),最大振幅较其明显上升(P<0.05);(3)甲苯胺蓝染色:模型组、实验对照组、实验组术后均出现神经纤维形态不规则,外膜不连续不清晰,轴突数量减少。术后第28天,实验组面神经形态与假手术无明显差异,较模型组及实验对照组有明显恢复;(4)Masson染色:各组造模后肌纤维数量减少,肌肉组织占比面积减少;实验组肌纤维形态较模型组及实验对照组恢复快,至术后第28天,肌纤维形态接近正常(P<0.05);(5)Western Bolt检测:各组造模后中枢面神经元组织GDNF的蛋白表达下降,观察期内逐渐增强;与模型组及实验对照组相比,术后各时间点,实验组中枢面神经元组织GDNF的蛋白表达显著增强(P<0.01)。结论 靶肌肉注射GDNF可作为改善周围神经损伤的有效Objective To observe effects of glial cell-derived neurotrophic factor(GDNF)target muscle injection on functional recovery,neuromorphology and GDNF expression in central facial neurons in rats after crushed facial nerve injury,so as to investigate the feasibility and mechanism of action of GDNF target muscle injection in the treatment of peripheral facial paralysis.Methods SD rats were randomly divided into sham-operated group(right facial nerve trunk exposed only),model group(facial nerve trunk pressed),experimental control group(facial nerve trunk pressed+buccal muscle injected with saline)and experimental group(facial nerve trunk pressed+buccal muscle injected with GDNF).The neurological recovery of rats was observed by buccal muscle electrophysiology,animal facial palsy score,morphological changes of buccal muscle fibers by Masson staining,morphological changes of facial nerve by toluidine blue staining and GDNF expression in facial neurons by Western Blot.Results①Immediately after modelling surgery,SD rats of the sham-operated group showed no facial paralysis with scores of 0,while peripheral facial paralysis appeared in those of the other groups with average scores of 5.Twenty-eight days after surgery,the rats in the experimental group had basically recovered from facial paralysis while those in the model and control groups had improved to different degrees but not fully recovered from facial palsy,with scores of more than 3.②Buccal muscle electrophysiology revealed that the peak latency was prolonged to different degrees and the maximum amplitude decreased to different degrees in each group compared with the sham-operated group.The peak latency was significantly shortened(P<0.05)and the maximum amplitude increased(P<0.05)over time in the experimental group compared with the model group and the experimental control group.③Toluidine blue staining showed irregular nerve fiber morphology,discontinuous and unclear outer membrane and reduced number of axons after surgery in the model group,the experimental

关 键 词：周围性面瘫 胶质细胞源性神经营养因子 电生理 面神经损伤 面神经元 

分 类 号：R764[医药卫生—耳鼻咽喉科]