肢体制动及被动活动对失神经支配骨骼肌超微结构及酶组织化学影响  

Limb immobilization and passive movement influence the ultrastructure and enzymic histochemistry of denervated muscle

作　　者：徐建广[1] 顾玉东[2] 李继峰[2] 

机构地区：[1]上海市第六人民医院 [2]复旦大学附属华山医院手外科

出　　处：《上海医学》2003年第12期921-923,共3页Shanghai Medical Journal

基　　金：上海市医学领先学科基金资助项目(1995 III 0 0 1)

摘　　要：目的　研究肢体制动及被动活动对失神经支配骨骼肌超微结构及酶组织化学的影响。方法　选用SD大鼠 ,建立双侧下肢失神经支配腓肠肌的实验模型 ,分别制动及被动活动右下肢 ,观察肌细胞的超微结构及Na+ K+ ATP酶和Ca2 + ATP酶活性变化。结果　肢体制动加速肌细胞线粒体、肌质网退变 ;制动侧Na+ K+ ATP酶下降速度较对照侧快 18.2 4 % ;Ca2 + ATP酶活性在术后 2周无明显差异 ,术后 4周制动侧较对照侧下降速度快 2 3.8%。被动活动延缓肢体肌细胞线粒体 ,肌质网退变 ;被动活动侧Na+ K+ ATP酶活性下降速度较对照侧慢 2 3.5 3% ;被动活动侧Ca2 + ATP酶活性下降速度较对照侧慢 2 7.94 %。结论　肢体制动可加速失神经支配肌肉萎缩的发生及发展 ,治疗中肢体制动范围及时间尽可能减少 ;Objective To study the influence of limb immobilization and passive movement on the ultrastructure and enzymic histochemistry of the denervated muscle.Methods SD rats were used for the model of denervated skeletal muscle by cutting the sciatic nerves of two lower limbs. The right lower limb was immobilized by inserting Kirschner pin into tibial and femoral marrow cavity in 16 SD rats. The left lower limb was given passive movement twice a day in another 16 SD rats. The myocyte ultrastructure, Na + K + ATPase and Ca 2+ ATPase activities were observed and recorded.Results The degeneration of mitochondria and sarcoplasmic reticulum were accelerated after limb immobilization. The rates of decline of Na + K + ATPase and Ca 2+ ATPase activities in the right lower limb were 18.24% and 23.8% respectively faster than those of the control side. Passive movement could protect the degeneration of mitochondria and sarcoplasmic reticulum. The decline rates of Na + K + ATPase and and Ca 2+ ATPase activities in the right lower limb were 23.53 per cent and 27.94 per cent slower respectively than those of the control side.Conclusion The limb immobilization can accelerate the development and severity of muscle atrophy. The time and range of limb fixation should be reduced as much as possible. Passive movement can delay the development of muscle atrophy, and is thus effective for its prevention and treatment.

关 键 词：肢体制动 被动活动 骨骼肌 超微结构 组织化学 失神经肌肉 周围神经损伤 NA^+-K^+-ATP酶活性 CA^2+-ATP酶活性 

分 类 号：R651.3[医药卫生—外科学]