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目的通过测定椎旁肌神经肌肉接头乙酰胆碱受体向突触后膜以外细胞膜面的扩散,判断脊髓空洞源性脊柱侧弯椎旁肌失神经支配的存在与否,并探讨与脊柱侧弯发生发展的关系。方法患儿分为3组:空洞-侧弯组25例,青少年特发性脊柱侧弯组16例,非脊柱侧弯组10例。切取脊柱左右两侧的骶棘肌组织,在-30℃下冰冻切片。乙酰胆碱受体用结合Texas Red-X的α-银环蛇毒素(红色荧光)染色,乙酰胆碱酯酶被结合Alexa Fluor 488的抗体(绿色荧光)染色。在共聚焦荧光显微镜下观察和拍照,红色荧光的强度和显影部位均明显大于绿色荧光为结果阳性。结果所有标本均成功双标荧光染色。非脊柱侧弯组和青少年特发性脊柱侧弯组标本中,脊柱左右两侧骶棘肌的检测结果均为阴性。空洞-侧弯组中14例出现阳性结果,阳性率为56.0%,其中凸侧阳性率为44.0%,凹侧阳性率为28.0%。在小脑扁桃体下移Ⅰ°与Ⅱ°以上组间,张力性空洞与非张力性空洞组间,空洞长度≤10个椎体与>10个椎体组间,Cobb角≤45°与Cobb角>45°组间,阳性率均无显著性差异(P>0.05)。结论脊髓空洞源性脊柱侧弯患儿椎旁肌乙酰胆碱受体发生了向突触后膜以外细胞膜面的扩散,提示存在椎旁肌失神经支配现象,椎旁肌肌力不平衡可能为导致此类脊柱侧弯的发生机制之一。
OBJECTIVE: To determine the presence or absence of neuromuscular denervation in paravertebral muscles of spinal cavitary scoliosis by measuring the diffusion of acetylcholine receptors in the paravertebral muscles to the membrane surface beyond the postsynaptic membrane and to explore the relationship with the development of scoliosis Relationship. Methods The children were divided into 3 groups: 25 cases of cavity-flexion group, 16 cases of idiopathic scoliosis group and 10 cases of non-scoliosis group. Musculoskeletal tissues from both sides of the spine were excised and frozen sections were frozen at -30 ° C. Acetylcholine receptors were stained with α-bungarotoxin conjugated to Texas Red-X (red fluorescence), and acetylcholinesterase was stained with antibody binding to Alexa Fluor 488 (green fluorescence). Observed and photographed under a confocal fluorescence microscope, the intensity of the red fluorescence and the development site were significantly greater than the green fluorescence as a positive result. Results All samples were successfully double-stained fluorescence staining. Non-scoliosis group and adolescent idiopathic scoliosis group specimens, both sides of the spinal sacral spinous muscle test results were negative. The positive results were found in 14 cases in the cavity - scoliosis group, with a positive rate of 56.0%, with a positive rate of 44.0% on the convex side and a positive rate of 28.0% on the concave side. In the cerebellar tonsil down Ⅰ ° and Ⅱ ° over the group, between the tension and non-stress cavities group, the length of the hole ≤ 10 vertebrae and> 10 vertebral body group, Cobb angle ≤ 45 ° and Cobb angle> 45 ° group, the positive rate was no significant difference (P> 0.05). Conclusions The proliferation of paravertebral muscle acetylcholine receptors outside of the posterior parasympathetic membrane in children with syringomyelia scoliosis suggests the existence of denervated paraspinal muscles and imbalance of paravertebral muscle strength may lead to this One of the mechanisms of scoliosis.