摘要
目的探讨颈椎关节突关节疼痛综合征并发上臂痛的神经解剖学机制.方法以抗降钙素基因相关肽(CGRP)抗体对SD大鼠C4～T1关节突关节囊作免疫组织化学染色.将荧光标记物快蓝(FB)和核黄(NY)分别注射到SD大鼠右侧桡神经和C1～T1颈椎关节突关节囊.显微镜下观察颈脊神经背根节(DRG)内被逆行荧光标记的神经元,再用抗CGRP抗体行免疫组织化学染色,观察DRG内的CGRP免疫阳性神经元.最后比较荧光照片和免疫组织化学照片上的神经元.结果C4～T1关节突关节囊上分布着丰富的CGRP免疫阳性神经纤维,它们或独立走行或交织成网.在C5～T1各节段的DRG中均可观测到被FB单标(76%)、NY单标(16%)和FB/NY双标(8%)的神经元.约40%的荧光逆行标记神经元在免疫组织化学染色的切片上呈CGRP免疫反应阳性.结论大鼠颈部DRG内一部分含GRP的感觉神经元的周围突分两支,一支支配颈椎关节突关节囊,另一支随桡神经分布到前(上)肢.提示,颈椎关节突关节疼痛综合征并发上臂牵涉痛的神经形态学基础之一可能发生在DRG水平.
Objective To understand the base of the neuroanatomy underlying the nociceptive syndrome occurring in cervical zygapophyseal joints, in which pain in upper limb was accompanied. Methods The capsules of the C4-T1 zygapophyseal joints of SD rats were immunostained with anti-calcitonin-gene-related peptide（CGRP） antibody, and a modified tricetry labeling was done as following ： the fluorescents, fast blue （FB） and nucleus yellow （ NY）, were injected, respectively, into the fight radial nerve and capsules of the zygapophyseal joints of neck, then, the ipsilateral dorsal root ganglia（DRG） were sectioned and the retrogradely labeled sensory neurons in the DRG were observed and photographed, finally, the sections were further immunostained with anti-CGRP antibody, eventually, the neurons in both of the photos labeled by fluorescents and anti-CGRP antibody were comparatively observed and analyzed. Results The nervers fibers containing CGRP distributed throughout the capsules of the zygapophyseal joints from C4-T1 in the rat. Most of these fibers coursed straightly and individually, and some of them anastomosed to each other to form the networks of the nerve fibors. The neurons retrograde labeled by fluorescents were observed in each of the DRG from C5-T1. These neurons shared a labeling populations of FB single（76% ）, NY single（ 16% ） and FB/YN double labeling （8%） respectively. Moreover, about 40% fluorescents labeled neurons were immunoreacted to CGRP. Conclusion The poripheral processes from a population of sensory neurons that contain CGRP in the cervical DRG simultaneously innervated both the capsules of cervical zygapophyseal joints and the fore limb with the radial nerve. The present results suggest that the nociceptive syndrome of cervical zygapophyseal joints with pain in human upper limb might be the referred pain occurring in the level of the DRG.
出处
《解剖学报》
CAS
CSCD
北大核心
2005年第4期361-366,共6页
Acta Anatomica Sinica
基金
复旦大学人才引进基金(BXF102302)
CMB康复医学基金资助项目
