早期与延迟减压对大鼠脊髓急性损伤并压迫模型的神经功能影响

发布时间：2019-02-17 17:35

【摘要】：目的:研究早期与延迟减压对大鼠脊髓急性损伤并压迫模型的神经功能影响,探讨不同减压时间对脊髓损伤后神经功能恢复有无差异,为临床脊髓急性损伤手术减压时限的选择提供实验依据和理论基础。方法:健康SD雌性大鼠68只,重量250-300g,随机分成四组:只行椎板切除无脊髓损伤对照A组(n=8)、脊髓撞击伤并压迫后6小时减压B组(n=20)、脊髓撞击伤并压迫后48小时减压C组(n=20)、脊髓撞击伤并持续压迫D组(n=20)。每组又按照手术后时间随机平均分为术后1d、7d、14d和28d四个小组(n=5),每只大鼠术前术后行BBB评分,然后取出损伤节段脊髓组织检测神经中丝蛋白(NF)化学活性的变化,TUNEL检测细胞凋亡,HE染色观察脊髓组织学变化。结果:1、BBB评分:SD大鼠造模后及减压术后1d,BBB评分约为2分,各组间无统计学差异(P0.05);术后7、14、28d各组大鼠BBB评分均明显低于A组,有明显统计学差异(P0.05),B组的BBB评分最高,D组的BBB评分最低。2、组织学观察结果2.1肉眼观察:造模后脊髓早期有充血水肿、中间凹陷。经减压后损伤脊髓矢状径恢复。2.2苏木精一伊红(HE)染色:A组脊髓无损伤;D组脊髓损伤程度最为明显,组织结构紊乱,损伤部位有明显空腔,周围瘢痕形成;B组损伤程度较C组小,损伤区脊髓无空洞,无明显瘢痕,与周围无明显界限;C组脊髓损伤区可见少量空泡细胞,周围有瘢痕形成。3、细胞凋亡T U N E L染色结果:A组几乎没有阳性细胞,其他各组损伤周围均可见较多阳性细胞,分布不均匀。B组术后脊髓TUNEL阳性细胞数在7d时最多,C、D组随着时间延长,阳性细胞数逐步减少,28 d后仍可见凋亡细胞。减压后相同时间内B组阳性细胞数较其他两组阳性细胞数明显减少,并且D组阳性细胞数最多,有明显统计学差异(P0.05)。4、免疫荧光染色:A组中见极少量NF-200阳性细胞。其余各组中随着时间的延长,NF阳性细胞数逐步增加,平均吸光度增强。术后1d B、C、D三组之间无统计学意义。术后7、14、28d,B组中NF-200的表达最高,D组阳性细胞数最少,差异有统计学意义(P0.05)。结论:1、手术减压对大鼠脊髓急性损伤并压迫模型的神经功能恢复具有促进作用。2、早期手术减压相对晚期手术减压神经功能恢复更为明显。
[Abstract]:Objective: to study the effects of early decompression and delayed decompression on the neural function of rats with acute spinal cord injury and compression, and to explore whether different decompression time has different effects on the recovery of nerve function after spinal cord injury. To provide experimental and theoretical basis for the selection of decompression time limit for clinical acute spinal cord injury. Methods: Sixty-eight healthy SD female rats, weighing 250-300g, were randomly divided into four groups: control group A (n = 8) treated with laminectomy only and decompression group B (n = 20) 6 hours after spinal cord impact injury and compression. Spinal cord impact injury and compression were performed 48 hours after decompression in group C (n = 20), spinal cord impact injury combined with continuous compression (n = 20). Each group was randomly divided into four groups according to the time of operation, one day, seven days, fourteen days and 28 days after operation. Each rat was given BBB score before and after operation, and then the changes of (NF) chemical activity of filaments in nerve were detected by taking out the injured spinal cord tissue. Apoptosis was detected by TUNEL and histological changes of spinal cord were observed by HE staining. Results: 1BBB score: the BBB score of SD rats was about 2 after modeling and 1 day after decompression (P0.05). The BBB scores of rats in each group were significantly lower than those in group A on the 7th day and 28th day after operation (P0.05). The BBB score of group), B was the highest, the BBB score of group D was the lowest (P0.05), and the BBB score of group D was the lowest (P < 0.05). Results of histological observation 2.1 observation with naked eyes: there were hyperemia and edema in the early stage of spinal cord. The sagittal diameter of the injured spinal cord recovered after decompression. 2.2 hematoxylin-eosin (HE) staining showed that there was no spinal cord injury in group A, the degree of spinal cord injury in group D was the most obvious, the tissue structure was disordered, the site of injury was obviously empty and the scar formed around the spinal cord. The degree of injury in group B was smaller than that in group C, and there was no syringomyelia and scar in the injured area. In group C, a small number of vacuole cells were found in the injured area of spinal cord, and scar formation was found around them. The results of T U N E L staining showed that there were almost no positive cells in group A, and more positive cells were found in all the other groups. The number of TUNEL positive cells in the spinal cord of group B was the highest at 7 days after operation, and the number of positive cells in group D decreased gradually with time, and the apoptotic cells were still seen 28 days later. At the same time after decompression, the number of positive cells in group B was significantly lower than that in the other two groups, and the number of positive cells in group D was the most (P0.05). Immunofluorescence staining: a very small number of NF-200 positive cells were found in group A. In other groups, the number of NF positive cells increased gradually and the average absorbance increased with time. There was no significant difference among the three groups on the 1st day after operation. The expression of NF-200 in group B was the highest, and the number of positive cells in group D was the least (P0.05). Conclusion: 1. Surgical decompression can promote the recovery of neural function in the model of spinal cord injury and compression. 2. The recovery of nerve function in early decompression is more obvious than that in late stage.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.2

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