皮肤神经活检技术在周围神经损伤中的应用研究
发布时间：2018-12-15 06:10
【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,P0.001;4周r=0.956,P0.001;6周r=0.936,P0.001;8周r=0.996,P0.001;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,P0.001;4周r=0.912,P0.001;6周r=0.728,P0.001;8周r=0.542,P0.001)。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。
[Abstract]:Objective: to explore the changes of skin neuropathies during peripheral nerve injury in rats by skin nerve biopsy technique, and to compare the correlation between the density of epidermal nerve fibers and sciatic nerve function index and nerve conduction velocity. To provide a reference for the evaluation of peripheral nerve injury. Methods: 50 Wistar rats were used to make sciatic nerve injury model on one side, and the contralateral sciatic nerve injury model was used as normal control. Skin nerve biopsy and immunohistochemistry were performed at 4 time points, 2 weeks, 4 weeks, 6 weeks and 8 weeks after operation. C5 eyepiece micrometer and Image-pro plus6.0 image analysis software were used to quantify the injured skin nerve fibers, and the sciatic nerve function index and nerve conduction velocity were measured. Correlation analysis of different stages and degree of recovery after nerve injury was carried out. Results: 1. The epidermal nerve fibers in the skin were highly immunoreactive to PGP9.5, and there were abundant nerve fibers innervated in the epidermis of the rat under microscope. 2. The normal reference value of IENFD in the back of the foot was 20.94 卤0.34 fibers / mm2.3, respectively. After sciatic nerve injury, IENFD decreased significantly, and IENFD increased gradually with the prolongation of postoperative recovery time. There was a positive correlation with the sciatic nerve function index and nerve conduction velocity (compared with the sciatic nerve function index score of the sciatic nerve injury side foot back IENFD: 2 weeks rr 0.977U P 0.001; At 4 weeks rn 0.956 P0.001 / 6 weeks r0.936 P0.001 / 8 weeks rr 0.996 / P0.001.Compared with the nerve conduction velocities of the lateral dorsal pedis of rats with sciatic nerve injury: 2 weeks rr 0.860 P 0.001 / 4 weeks r0.912 P 0.001; (4) the curve of numerical change of IENFD was steeper and the speed of recovery was faster during the recovery of injury. Conclusion: skin nerve biopsy can be used to evaluate the peripheral nerve injury. The dynamic changes of IENFD in the recovery process of sciatic nerve injury have strong correlation with sciatic nerve index and nerve conduction velocity, and are consistent with the severity of the lesion. IENFD may be more sensitive to the assessment of peripheral nerve injury than the other two.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R745
本文编号：2380117
[Abstract]:Objective: to explore the changes of skin neuropathies during peripheral nerve injury in rats by skin nerve biopsy technique, and to compare the correlation between the density of epidermal nerve fibers and sciatic nerve function index and nerve conduction velocity. To provide a reference for the evaluation of peripheral nerve injury. Methods: 50 Wistar rats were used to make sciatic nerve injury model on one side, and the contralateral sciatic nerve injury model was used as normal control. Skin nerve biopsy and immunohistochemistry were performed at 4 time points, 2 weeks, 4 weeks, 6 weeks and 8 weeks after operation. C5 eyepiece micrometer and Image-pro plus6.0 image analysis software were used to quantify the injured skin nerve fibers, and the sciatic nerve function index and nerve conduction velocity were measured. Correlation analysis of different stages and degree of recovery after nerve injury was carried out. Results: 1. The epidermal nerve fibers in the skin were highly immunoreactive to PGP9.5, and there were abundant nerve fibers innervated in the epidermis of the rat under microscope. 2. The normal reference value of IENFD in the back of the foot was 20.94 卤0.34 fibers / mm2.3, respectively. After sciatic nerve injury, IENFD decreased significantly, and IENFD increased gradually with the prolongation of postoperative recovery time. There was a positive correlation with the sciatic nerve function index and nerve conduction velocity (compared with the sciatic nerve function index score of the sciatic nerve injury side foot back IENFD: 2 weeks rr 0.977U P 0.001; At 4 weeks rn 0.956 P0.001 / 6 weeks r0.936 P0.001 / 8 weeks rr 0.996 / P0.001.Compared with the nerve conduction velocities of the lateral dorsal pedis of rats with sciatic nerve injury: 2 weeks rr 0.860 P 0.001 / 4 weeks r0.912 P 0.001; (4) the curve of numerical change of IENFD was steeper and the speed of recovery was faster during the recovery of injury. Conclusion: skin nerve biopsy can be used to evaluate the peripheral nerve injury. The dynamic changes of IENFD in the recovery process of sciatic nerve injury have strong correlation with sciatic nerve index and nerve conduction velocity, and are consistent with the severity of the lesion. IENFD may be more sensitive to the assessment of peripheral nerve injury than the other two.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R745
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