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目的探讨血管内皮细胞生长因子(VEGF)的表达对周围神经嵌压症病理损伤和神经功能损害的保护作用。方法将80只SD大鼠按体重随机分层分组制作坐骨神经嵌压性损害的动物模型,取嵌压后第12小时、72小时、7天与第4周的大鼠坐骨神经,分别采用免疫组化与病理学、电生理学的方法检测VEGF水平与病理变化、神经传导速度、脊髓神经元计数等,并将各项检测结果进行对比,运用正常对照组、模型组、前列地尔组和盐酸丁咯地尔组采用SAS统计软件9.1.3进行方差分析统计处理。结果(1)嵌压大鼠坐骨神经后,除正常对照组外12h起各组背根神经节细胞VEGF表达开始增加,72h达到高峰后开始下降,一周时接近正常水平,正常对照组只轻度表达。与正常对照组比较,其余各组各时段背根神经节细胞VEGF表达水平均显著增加(P<0.05),前列地尔组和盐酸丁咯地尔组较模型组为优(P<0.05)、表达的数量增加、持续时间延长。(2)嵌压大鼠坐骨神经4周后,正常对照组正常,其余各组病理变化、脊髓神经元计数均明显较正常对照组差(P<0.01);而前列地尔组和盐酸丁咯地尔组第4周时上述诸项结果虽较正常对照组差(P<0.05),但均较模型组为优(P<0.05)。(3)嵌压大鼠坐骨神经4周时,正常对照组正常,其余各组大鼠坐骨神经传导速度均明显较正常对照组差(P<0.01);而前列地尔组和盐酸丁咯地尔组第4周时上述诸项结果虽较正常对照组差(P<0.05),但均较模型组为优(P<0.05)。(4)VEGF表达增加组之病理改变减轻、神经功能恢复增加。结论对于周围神经嵌压性损害,VEGF表达的增加可减轻周围神经病理损害、提高神经传导速度、促进周围神经损伤的修复。
Objective To investigate the protective effect of vascular endothelial growth factor (VEGF) expression on the pathological damage of peripheral entrapment and neurological impairment. Methods Eighty SD rats were randomly divided into groups according to body weight to make the animal model of entrapment injury of sciatic nerve. The rats were subjected to immunohistochemistry (IHC) on the 12th, 72th, 7th, And pathological, electrophysiological methods to detect VEGF levels and pathological changes, nerve conduction velocity, spinal cord neurons count, and the results of the test were compared using the normal control group, model group, alprostadil and buprenorphine Local group using SAS statistical software 9.1.3 ANOVA statistical processing. RESULTS: (1) VEGF expression began to increase in dorsal root ganglion cells of rats in each group 12 h after instillation of sciatic nerve, and then began to decrease at 72 h peak, approached to the normal level at one week, and only mildly expressed in normal control group . The levels of VEGF in dorsal root ganglion cells in each group were significantly higher than those in the normal control group (P <0.05), and the alprostadil and buflomedil hydrochloride groups were superior to the model group (P <0.05) The number of expressions increases and the duration increases. (2) After 4 weeks of instillation of rat sciatic nerve, the normal control group was normal. The pathological changes and neuron counts of spinal cord in the remaining groups were significantly lower than those in the normal control group (P <0.01); while the alprostadil group and bupivacaine hydrochloride Compared with the normal control group, the results of the above 4 weeks were worse than those of the normal control group (P <0.05), but both were better than the model group (P <0.05). (3) When the sciatic nerve of rats was inlayed for 4 weeks, the normal control group was normal, and the conduction velocity of sciatic nerve in the other groups was significantly lower than that in the normal control group (P <0.01); while the alprostadil group and the buflomedil hydrochloride group The results of the above 4 weeks were worse than those of the normal control group (P <0.05), but they were better than the model group (P <0.05). (4) The pathological changes of the group with increased VEGF expression were alleviated, and the recovery of nerve function increased. Conclusions Peripheral nerve entrapment injury can increase the expression of VEGF and reduce the peripheral neuropathological damage, improve the nerve conduction velocity and promote the repair of peripheral nerve injury.