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目的观察脊髓背角糖皮质激素受体(glucocorticoid receptor,GR)在慢性病理性神经痛中的作用。方法成年SD大鼠分为假手术组、坐骨神经慢性压迫损伤(CCI)组、CCI+生理盐水组、CCI+RU38486治疗组。测定各组大鼠不同时间点热缩足反射潜伏期(TWL);CCI组于术后7、14 d处死大鼠,取L4～L6脊髓冰冻切片,应用免疫组织化学方法观察GR表达变化;大鼠蛛网膜下腔埋管,于CCI术后1～14 d鞘内注射生理盐水、GR拮抗剂RU38486,测定其对TWL的影响。结果 CCI大鼠术后1 d损伤侧下肢TWL即显著降低,到第14天热疼敏仍持续存在;术后7、14 d损伤侧L4～L6节段脊髓背角GR表达显著增加(P<0.05);术后1～14 d鞘内给予GR拮抗剂RU38486可明显减轻CCI所致的热疼敏。结论脊髓背角糖皮质激素受体的激活可促进坐骨神经慢性压迫损伤所致的神经痛的发生和维持。
Objective To observe the effect of glucocorticoid receptor (GR) in spinal dorsal horn on chronic pathological neuralgia. Methods Adult SD rats were divided into sham operation group, chronic constriction injury (CCI) group, CCI + saline group and CCI + RU38486 treatment group. Rats in CCI group were sacrificed at 7 and 14 days after operation. Frozen sections of L4 ~ L6 spinal cord were harvested, and the expression of GR was observed by immunohistochemistry. Rats The subarachnoid tube was cannulated. Intrathecal injection of physiological saline and GR antagonist RU38486 1 to 14 days after CCI was performed to determine its effect on TWL. Results The level of TWL was significantly decreased in CCI rats on the first day after injury, and remained on the 14th day after injury. GR expression was significantly increased in spinal dorsal horn of L4 ~ L6 segment on the 7th and 14th day after operation (P < 0.05). Intrathecal administration of RU38486, a GR antagonist, at 1 ~ 14 days postoperatively could significantly reduce the heat pain sensitivity induced by CCI. Conclusion The activation of glucocorticoid receptor in spinal dorsal horn can promote the occurrence and maintenance of neuralgia induced by chronic compression injury of sciatic nerve.