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神经束植入联合甲钴胺治疗失神经骨骼肌的实验研究

The experimental study of nerve tract implantation combined with Methycobal in denervated skeletal muscle

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【作者】 陈飞高峰黄刚李保龙杨延军

【Author】 CHEN Fei;GAO Feng;HUANG Gang;Department of Hand Surgery,Shenzhen Longgang Hospital;

【机构】 深圳市龙岗中心医院手外科

【摘要】 目的 研究神经束植入治疗失神经支配骨骼肌,并比较靶肌肉局部用药与全身性用药的疗效,探讨神经营养药物应用的最佳给药方法。方法 选用雄性大鼠60只随机等分5组,每组12只,制作左侧胫神经切断动物模型。A组:神经束植入组;B组:神经束植入+左侧腓肠肌注射甲钴胺;C组:神经束植入+腹腔注射甲钴胺;D组:胫神经切断;E组:胫神经切断+左侧腓肠肌注射生理盐水。术后当日开始,B组隔日左侧腓肠肌注射甲钴胺300μg/kg;C组隔日腹腔注射甲钴胺300μg/kg;E组隔日左侧腓肠肌注射等渗盐水0.02 rml。分别于术后4周和8周测量左小腿腓肠肌电生理、肌纤维横截面积和肌细胞TUNEL染色。结果 术后4周及8周,A,B,C三组腓肠肌电位波幅组间比较差异均有显著性(P<0.05);D组与E组腓肠肌纤颤电位波幅差异无显著性(P>0.05)。术后4周及术后8周,肌纤维横截面积和肌细胞TUNEL阳性细胞数A,B,C组间差异均有显著性(P<0.05),D,E组间差异无显著性(P>0.05),A,B,C组与D,E组差异有显著性(P<0.05)。B组明显优于其他组。结论 神经束植入能有效防治失神经骨骼肌萎缩,靶肌肉给药效果优于全身用药。

【Abstract】 Objective To study of nerve tract implantation in denervated skeletal muscle,and compare the efficacy of target skeletal muscle local and systemic medication,to investigate the best administration method of the neurotrophic drug application.Methods cutting off left tibial nerve,it was established in 60male rats that were randomly divided into 5 groups,with 12 each.Nerve tract implantation in gastrocnemius(group A),nerve tract implantation and injection of Methycobal in gastrocnemius(group B),nerve tract implantation and injection of Methycobal in abdomen(group C),left tibial nerve cut off(group D),left tibial nerve cut off and injection of Methycobal in gastrocnemius with physiological saline(group E).The rats of group B were injected Methycobal(300 |xg/kg) in the gastrocnemius every other day each.The rats of group C were injected Methycobal(300 |Xg/kg) in abdomen every other day each.The rats of group E were injected physiological saline(0.02 ml) in the gastrocnemius every other day each.Electrophysiology,the myocyte diameter of the gastrocnemius and TUNEL staining of the gastrocnemius cells were done in 4 weeks and 8 weeks after surgery.Results The gastrocnemius potential volatility was statistical difference among the A,B,and C group in 4 weeks and 8 weeks after surgery(P <0.05) and no statistical difference in the gastrocnemius fibrillation potential amplitude between group D and group E(P>0.05).The myocyte cross section of the gastrocnemius and TUNEL staining of the gastrocnemius cells was statistical difference among all the groups in 4 weeks and 8 weeks after surgery(P < 0.05)except with no statistical difference between group D and group E(P>0.05).Group B was significandy better than the other groups.Conclusion Nerve tract implantation in denervated skeletal muscle can effectively prevent denervated skeletal muscle from atrophy,and the administration of Methycobal of the target muscle is better than systemic administration.

【基金】 深圳市科技计划项目(医疗卫生类)(项目编号:20113257)
  • 【文献出处】 实用手外科杂志 ,Journal of Practical Hand Surgery , 编辑部邮箱 ,2013年02期
  • 【分类号】R651.3
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