高压氧治疗对神经病理性疼痛的影响及其机制研究  

Effect of hyperbaric oxygen therapy on neuropathic pain and its mechanism

作　　者：陈伟[1] 汪海 王鑫 刘灿[1] 陈永权[1] Chen Wei;Wang Hai;Wang Xin;Liu Can;Chen Yongquan(Department of Anesthesiology,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China;Department Of Cardiac Surgery,the First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China;Department of Cardiac Surgery,Maanshan People's Hospital,Maanshan 243000,China)

机构地区：[1]皖南医学院第一附属弋矶山医院麻醉科,芜湖241000 [2]皖南医学院第一附属弋矶山医院心脏大血管外科,芜湖241000 [3]马鞍山市人民医院麻醉科,马鞍山243000

出　　处：《中华航海医学与高气压医学杂志》2024年第2期224-228,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：皖南医学院校中青年科研基金(WK2021F18);皖南医学院校中青年科研基金(WK2019F17);安徽高校自然科学研究项目(KJ2020A0605)。

摘　　要：目的探讨高压氧(HBO)治疗减轻神经病理性疼痛的机制。方法96只成年健康雄性C57BL/6J小鼠,采用随机数字表法分为假手术组(S组)、模型组(C组)和高压氧组(H组),每组32只。C组和H组采用坐骨神经慢性压迫损伤法建立神经病理性疼痛模型,S组仅行假手术。H组于术后第1天给予HBO处理,1次/d,连续处理5 d;S组和C组单纯放入氧舱,不接受HBO处理。造模后分别于术后第1、3、7、14、21、28天检测各组小鼠的机械反射阈值(WMT)和热反射潜伏期(TWL)。每组于术后第7、14、21、28天各处死8只小鼠,取右侧背根神经节,RT-qPCR法测定各组小鼠的背根神经节低氧诱导因子-1α(HIF-1α)、诱导型一氧化氮合酶(iNOS)、精氨酸酶1(Arg-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-10 mRNA的表达水平。结果与S组比较,C组小鼠各时点的MWT明显降低,TWL明显缩短(P<0.001),HIF-1α、iNOS、TNF-α、IL-6 mRNA的表达水平明显升高,而Arg-1、IL-10 mRNA的表达水平明显降低(P<0.05、P<0.01或P<0.001)。与C组相比较,H组小鼠术后第1、3、7、14天的MWT明显升高,TWL明显延长(P<0.001),术后第7、14天的HIF-1α、iNOS、TNF-α、IL-6 mRNA表达水平明显降低,Arg-1、IL-10 mRNA表达水平明显升高(P<0.01或P<0.001)。结论HBO治疗对小鼠神经病理性疼痛短时程有效,其机制可能是通过调控HIF-1α介导的巨噬细胞极化、发挥抗炎作用有关。Objective To explore the mechanism of hyperbaric oxygen(HBO)therapy for alleviating neuropathic pain.Methods A total of 96 adult healthy male C57BL/6J mice were divided into three groups,according to the random number table method:sham group(group S),model of chronic compression injury group(group C),and HBO group(group H),with 32 mice in each group.The neuropathic pain model in the group C and group H was established by chronic compression injury(CCI)of sciatic nerve,and sham operation was performed only in the group S.The mice in the group H were treated with HBO on the first day after operation,once a day for five consecutive days.The mice in the group S and group C were simply placed in oxygen chamber without HBO treatment.After modeling,the mechanical withdrawal threshold(MWT)and thermal withdrawal latency(TWL)were measured on postoperative days 1,3,5,7,14,21,and 28,respectively.On postoperative days 7,14,21,and 28,eight mice were euthanized in each group and the right dorsal root ganglia were harvested.The mRNA expression levels of HIF-1α,iNOS,Arg-1,TNF-α,IL-6,and IL-10 in the dorsal root ganglia of each group were determined by RT-qPCR.Results Compared with the group S,at each postoperative time point,the group C had lower MWT and shorter TWL(P<0.001),higher mRNA expression levels of HIF-1α,iNOS,TNF-α,and IL-6,and lower mRNA expression levels of IL-10 and Arg-1(P<0.05,P<0.01,or P<0.001).Compared with the group C,the mice in the group H showed significant increases in MWT and TWL on postoperative days 1,3,7,and 14(P<0.001),and on postoperative days 7 and 14,the mRNA expression levels of HIF-1α,TNF-α,IL-6,and iNOS were significantly decreased,while the mRNA expression levels of Arg-1 and IL-10 were significantly increased(P<0.01 or P<0.001).Conclusion HBO therapy is effective for short-term relief of neuropathic pain in mice,and its mechanism may be related to the regulation of macrophage polarization mediated by HIF-1αand its anti-inflammatory effects.

关 键 词：高压氧 神经病理性疼痛 机械缩足反射阈值 热缩足反射潜伏期 

分 类 号：R741[医药卫生—神经病学与精神病学]