摘要
目的:分析预防使用大剂量甲基强的松龙对急性脊髓损伤大鼠运动诱发电位的影响及对神经功能的保护作用。方法:实验于2004-05在上海医药工业研究所实验动物中心完成,选择健康SD大鼠40只(鼠龄3个月),随机分成脊髓损伤模型组和甲基强的松龙预防使用组穴甲基强的松龙组雪,按照取材时间不同分为24h熏72h两个时间点,每个时间点10只。采用Allen’s重物打击脊髓损伤模型。显微镜下无菌暴露T8～9脊髓,在暴露的硬膜表面放置3mm×2mm的弧形垫片,将圆柱状金属棒沿细玻璃导管垂直、自由落下,制成脊髓损伤模型。重物重量10g,高度5cm,致伤能量50(g·cm)。脊髓损伤模型组椎板切除后进行重物打击,打击前30min由尾静脉推注生理盐水1mL;甲基强的松龙组椎板切除后重物打击,打击前30min由尾静脉推注甲基强的松龙30mg/kg。然后关闭切口。在脊髓损伤后24h、72h进行神经功能评分及标本的取材。并进行Molt斜板功能评分、脊髓病理形态学观察和运动诱发电位检测。结果:每组每个时间点10只动物无死亡,全部进入结果分析。①甲基强的松龙组脊髓损伤后24h熏72h时的Molt斜板功能评分均高于脊髓损伤模型组,其中脊髓损伤后24h差异无显著性,脊髓损伤后72h差异有显著性意义眼穴42.5±3.37雪°,穴24.3±2.41雪°,P<0.0001演。②甲基强的松龙组脊髓损伤后24h,72h时运动诱发电位潜伏期均短于脊髓损伤模型组,其中脊髓损伤后24h差异无显著性意义;脊髓损伤后72h差异有显著性意义眼(7.84±0.64),(9.61±0.74)ms熏P<0.0001演。③甲基强的松龙组脊髓损伤后24h和72h的运动诱发电位波幅变化率较脊髓损伤模型组均显著增高,差异有显著性意义眼(58.67±8.99)%,(34.79±8.84)%,P<0.0001演;眼(65.89±8.27)%,(40.45±9.61)%,P<0.0001演。④与脊髓损伤模型组比较,甲基强的松龙组脊髓组织肿胀较轻,出血较少,胞浆空泡化及核固缩现象减少;白质轴突水肿、空泡变性减轻。结论:预防使用大剂量甲基强的松龙可明显改善损伤脊髓的病理形态,改善损伤脊髓的运动诱发电位,改善损伤脊髓的神经功能,对大鼠急性脊髓损伤有神经保护作用。
AIM： To analyze the preventive effect of high-dose methylprednisolone on acute spinal cord injury in rats, especially effect in motor evoked potential.
METHODS： The study was conducted in May 2004 in Experimental Animal Center, Shanghai Institute of Pharmaceutical Industry. Forty healthy SD rats （age 3 months） were randomly divided into two groups： spinal cord injury group, methylprednisolone in prophylaxis group, and there was 24 hours and 72 hours time point according to different drawing materials time, and 10 rats in each time point. Allen＇s weight drop model of spinal cord injury was prepared. A 3 mm×2 mm arcuate backup plate was put on the surface of the eighth or ninth thoracic spine revealed in microscope. The spine was injured when the cylindrical metal rod fell in free within a small grass tube. The wounding energy was 50 （g ·cm） with weight of 10 g and height of 5 cm. 1 mL saline was administrated through caudal vein thirty minutes before beat in the spinal cord injury group. Methylprednisolone was administrated through caudal vein in 30 mg/kg thirty minutes before beat in methylprednisolone in prophylaxis group, and then the opening incision was closed. Malt＇s inclined plane scales, pathological changes of spinal cord and motor evoked potentials at 24- and 72-hour after spinal cord injury were respectively studied after the neurofunctional score and sample drawing.
RESULTS： There was no death at each time point and all the animals were involved in the result analysis. ①Molt＇s inclined plane scales in the methylpredniselone in prophylaxis group was higher than that in the spinal cord injury group 24 and 72 hours after spinal cord injury, and the difference was insignificant at 24 hours after spinal cord injury, while at the 72 hours after spinal cord injury there was marked significance [（42.5 ±3.37）°,（24.3±2.41）° ,P 〈 0.000 1]. ②Latency of motor evoked potentials in the methylprednisolone in prophylaxis group at 24 and 72 hours after spinal cord injury was shorter than that in the spinal cord injury group, and at 24 hours after spinal cord injury there was no marked significance, while at 72 hours after spinal cord injury there was obvious difference [（7.84±0.64）, （9.61±0.74） ms,P 〈 0.000 1]. ③The ratio of motor evoked potential amplitude were significantly improved in 24- and 72-hour after spinal cord injury in the methylprednisolone in prophylaxis group as compared with the spinal cord injury group, which had marked significance [（58.67±8.99）%, （34.79±8.84）% ,P 〈 0.000 1]; [（65.89±8.27）%, （40.45 ±9.61 ）% ,P 〈 0.000 1]. ④Compared with the spinal cord injury group, there was the mild swelling of spinal cord tissues, slightly bleeding, reduction of vacuolization of endochylema and karyopycnosis, hydrosarca of white matter axiscylinder, abatement of vacuolar degeneration in the methylprednisolone in prophylaxis group.
CONCLUSION： High-dose methylprednisolone can preventively improve pathological formation, motor evoked potentials and neurofunction of injured spinal cord, and it also has neuroprotective effect on acute spinal cord injury of rats.
出处
《中国临床康复》
CSCD
北大核心
2006年第20期98-100,共3页
Chinese Journal of Clinical Rehabilitation
