【作者】 李颖；

【导师】 凌丽；

【作者基本信息】 河北大学 ， 神经病学， 2017， 硕士

【摘要】 目的:应用皮肤神经活检技术初步探索大鼠周围神经损伤时皮肤神经病理的改变,比较表皮神经纤维密度与坐骨神经功能指数、神经传导速度测定结果的相关性,为周围神经损伤的评估提供参考依据。方法:采用Wistar大鼠50只,单侧进行大鼠坐骨神经损伤模型制作,对侧作为正常对照,在术后2周、4周、6周、8周4个时间点,通过皮肤神经活检、免疫组织化学技术,采用C5型目镜测微尺及Image-pro plus6.0图像分析软件对损伤后的皮肤神经纤维进行定量,同时进行各个时段的坐骨神经功能指数测定和神经传导速度检测,对神经损伤后不同阶段及恢复程度进行各个指标的相关性分析。结果:1、皮肤中的表皮神经纤维对PGP9.5有高度免疫反应性,镜下可见大鼠表皮有丰富的神经纤维支配。2、大鼠足背部IENFD正常参考值为20.94±0.34fibers/mm2。3、在坐骨神经损伤后,IENFD呈明显下降,随着术后恢复时间的逐渐延长,IENFD呈逐渐升高的趋势,且与坐骨神经功能指数及神经传导速度均呈正相关(大鼠坐骨神经损伤侧足背部IENFD与坐骨神经功能指数评分比较:2周r=0.977,P<0.001;4周r=0.956,P<0.001;6周r=0.936,P<0.001;8周r=0.996,P<0.001;大鼠坐骨神经损伤侧足背部IENFD与神经传导速度比较:2周r=0.860,P<0.001;4周r=0.912,P<0.001;6周r=0.728,P<0.001;8周r=0.542,P<0.001)。4、IENFD在损伤恢复过程中数值变化曲线更陡峭,恢复速度更快。结论:皮肤神经活检可用于周围神经损伤的评估,IENFD在坐骨神经损伤后恢复过程中的动态变化与坐骨神经指数、神经传导速度有很强相关性,且与病变的严重程度相一致,相对于其他两项指标,IENFD对于周围神经损伤的评估可能更敏感。更多还原

【Abstract】 Objective:The neuropathic changes of the skin were investigated by skin biopsy technique.The correlation between epidermal nerve fiber density and sciatic nerve function index and nerve conduction velocity was compared.For the assessment of peripheral nerve injury to provide a reference.Methods:A total of 50 rats were randomly divided into two groups.The rats were randomly divided into two groups: control group(n = 10),control group(n = 6)Technique was used to quantify the damaged skin nerve fibers by C5 eyepiece micrometer and Image-pro plus6.0 image analysis software.At the same time,the sciatic nerve function index and nerve conduction velocity were measured at different time points.After the different stages of nerve injury And the degree of recovery of the indicators of the correlation analysis.Results: 1,with PGP9.5 marked nerve fibers,showing that the epidermis is rich in nerve fibers dominated.The normal reference value of IENFD in the dorsal foot of the rat was 20.94 ± 0.34 fibers / mm2.2.The IENFD and sciatic nerve function index scores of the sciatic nerve injury in the sciatic nerve injury were positively correlated at each time point(2 weeks r = 0.977,P <0.001;4 Week r = 0.956,P <0.001;6 weeks r = 0.936,P <0.001;8 weeks r = 0.996,P <0.001);rat sciatic nerve injury side of the foot IENFD and nerve conduction velocity results at all time points were positively correlated(2 weeks r = 0.860,P <0.001;4 weeks r = 0.912,P <0.001;6 weeks r = 0.728,P <0.001;8 weeks r = 0.542,P <0.001).Conclusions:Skin biopsy can be used to assess the peripheral nerve injury.IENFD is consistent with the sciatic nerve index and nerve conduction velocity during the recovery of sciatic nerve injury.更多还原