大鼠周围神经移植修复后脊髓前角运动神经元变化的动态观察
阚世廉,李桂石,詹海华,张建兵,马宁,李明新,赵嘉国
中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (5) : 534-539.
大鼠周围神经移植修复后脊髓前角运动神经元变化的动态观察
Changes of motor neurons in spinal cord anterior horn after peripheral nerve graft repair in rat
目的 观察大鼠移植神经远侧吻合口再通术后脊髓前角细胞形态及功能变化，为长段神经移植后行远侧吻合口再通术提供理论支持。 方法 实验采用SD大鼠120只，随机分为6组，分别为：(1)神经单纯切断组；(2)神经切断缝合组；(3)神经移植修复组；(4)游离神经移植修复后远侧缝合口切除组；(5)游离神经移植修复后远侧缝合口切除再缝合组; (6)假手术组。术后1、2、4、8、12和16周取出脊髓腰膨大，进行组织学观察和免疫组化检测。 结果 实验组术后1周胞浆轻度水肿，线粒体肿胀，空泡化。术后2~4周，神经元超微结构的改变明显加重，术后4~8周进入恢复期。第3组术后1周，BDNF在运动神经元内表达开始增加，2周达到了高峰，8周下降。NGF的表达在术后2周开始上升， 8周达到高峰，之后持续下降。第5组BDNF的表达在术后8~16周期间呈上升趋势，NGF的表达在术后8周一直维持平稳状态，而对照组各时间段无明显变化。 结论 长段神经移植修复术后，适时行远侧吻合口切除重新吻合，既去除了远侧吻合口的瘢痕，同时再次激活神经元功能的状态，有利于功能恢复。
Objective To observe morphologic and functional changes of motor neurons of spinal cord horn in the rat transplanted nerve model, and to provide theoretical foundation for the distal anastomostic re-suture of theperipheral transplanted nerve. Methods 120 SD rats were randomly divided into six groups respectively: a pure nerve transection (group 1); a suture after nerve transection (group 2); a nerve graft repair after nerve transaction (group 3); a distal anastomosis resection after free nerve graft repair (group 4); a re-suture of distal anastomosis resection after free nerve graft repair (group 5); a sham operation (group 6). The lumbar enlargement of the spinal cord were removed to detect histological changes at 1st week, 2nd week, 4th week, 8th week, 12th week, 16th week， respectively. Pathologic changes of white and gray matter in each group were observed using a light microscope at each postoperative time point. And the expression of various neurotrophic factor receptors in the anterior motor horn of the spinal cord was observed using immunohistochemistry. Results Experimental group showed cytoplasmic edema, mitochondrial swelling, and vacuolization at postoperative 1st week. And the changes of neuronal ultrastructure significantly increased at 2nd to 4th week. Electron microscope images suggested the damaged neurons had been into the recovery period at 4th to 8th week. Group 3 showed the increase of BDNF expression in motor neurons at 1st week, reaching a peak at 2nd week, and declining at 8th week. NGF expression increased at 2nd week, reaching a peak at 8td week, and declining at 8th week. BDNF expression gradually increased at 8th to 16th week in group 5. NGF Expression maintained a steady state after 8th week, without a downward trend. the control group did not showed significant changes at each time. Conclusions Re-suture of distal anastomosis resection after long nerve graft repair can promote the recovery of neurological function at a proper time, because it removes the distal anastomotic scar and activates the endocrinic state of the neurons in the anterior horn of the spinal cord.
周围神经损伤 / 运动神经元 / 凋亡 / 超微结构 / 修复再生 / 免疫组化
Peripheral nerve injury / Motor neurons / Apoptosis / Repair and regeneration / BDNF / NGF
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