摘要
目的:通过大鼠鞘内注射免疫抑制剂地塞米松,探讨其对神经病理性疼痛的影响及机制,为疼痛的治疗提供新的途径。方法:将36只SD大鼠随机分成假手术+盐水治疗组、坐骨神经慢性压迫损伤(CCI)+盐水治疗组、CCI+地塞米松治疗组,每组12只。采用改良CCI法制作神经病理性疼痛模型,假手术+盐水治疗组只暴露坐骨神经而不予结扎,CCI+地塞米松治疗组大鼠于术后即刻、2、4、6、8、10、12天通过鞘内放置的PE-10导管予地塞米松0.5 mg(约0.1 mL),假手术+盐水治疗组和CCI+盐水治疗组大鼠在相同时间点予等容量的0.9%氯化钠。于术后1、3、7、14天测定大鼠的机械痛阈值,并于术后14天将大鼠处死,应用免疫组化技术测定其脊髓星形胶质细胞神经胶质原纤维酸性蛋白(GFAP)及肿瘤坏死因子-α(TNFα-)的表达。结果:坐骨神经结扎后痛阈下降,术后1、3、7、14天,CCI+盐水治疗组和CCI+地塞米松组的痛阈与假手术+盐水治疗组比较差异有统计学意义(P<0.01);CCI+地塞米松组痛阈与CCI+盐水治疗组比较有统计学意义(P<0.05)。免疫组化测定:假手术+盐水治疗组GFAP染色及TNFα-染色以阴性居多,CCI+盐水治疗组和CCI+地塞米松组GFAP染色为强阳性;CCI+盐水治疗组TNFα-染色弱阳性居多,CCI+地塞米松组TNFα-染色以强阳性居多,两者比较差异有统计学意义(P<0.05)。结论:地塞米松对神经病理性疼痛有明显的治疗作用。
Objective：To investigate the effect and the likely mechanism of immune inhibitor dexamethasone in the treatment of the chronic neuropathic pain by intrathecal injection and to suggest a new approach to the treatment. Methods：36 SD rats were divided into 3 groups. Group A （n = 12, sham operation ＋ saline treatment） ;Group B （n = 12, chronic constrained injury ＋ saline treatment） ;Group C（n = 12,chronic constrained injury ＋ dexamethasone）. Sciatic nerve ligature was performed classically in Group B and C to construct CCI model. The sciatic nerve of rats in Group A were exposed only,with no ligation. Dexamethasone was administered through PE-10 tube in Group C in 2,4,6,8,10,12 after operation,while the rats of Group A and B were given equal amount of saline at the same time. Pain threshold was recorded 1,3,7,14 days after operation. The rats were sacrificed at the end of the 2nd week,and the GFAP and the expression of TNF-α in spinal cord were determined by immunohistochemistry. Results： ①Behavioral tests of threshold： compared to that of Group A,the threshold of Group B and C decreased after CCI operation（P 〈 0. 01 ） ;compared to that of Group B ,the hyperalgesia showed a withdrawal postligation of sciatic verve in group C. ②Immunohistochemistry：a. GFAP staining： Spinal astrocytie activity was elevated in rats of Group B and C except of the sham group（P 〈0. 05）. b. TNF-α expression：TNF- α expression of Group B tended to be weak-postive,but that of Group Ctended to be strong-positive. There was statistical significance, when compared（P 〈 0. 05） . Conclusion：Dexamethasone has obvious therapeutic effect in the treatment of the chronic neuropathie pain.
出处
《临床误诊误治》
2008年第11期7-11,F0003,共6页
Clinical Misdiagnosis & Mistherapy
关键词
免疫抑制剂
糖皮质激素类
地塞米松
注射
脊髓
神经痛
Immune depressant
Glucocorticoid
Dexamethasone, injection
Spinal cord
Neuralgia
