中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (7): 1172-1176.doi: 10.4103/1673-5374.211199

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

改变终末效应器条件下感觉神经短期内的再生特点

  

  • 收稿日期:2017-05-26 出版日期:2017-07-15 发布日期:2017-07-15
  • 基金资助:

    国家重点基础研究发展计划（973计划）项目（2014CB542201），国家高技术研究发展计划（863计划）项目（SS2015AA020501），国家自然科学基金项目（31571235, 31571236, 31271284, 31171150），教育部创新团队项目（IRT1201），教育部新世纪优秀人才支持项目（BMU20110270），公共卫生专项基金项目（201302007）

Short-term observations of the regenerative potential of injured proximal sensory nerves crossed with distal motor nerves

Xiu-xiu Zhang, Yu-hui Kou, Xiao-feng Yin, Bao-guo Jiang, Pei-xun Zhang   

  1. Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing, China
  • Received:2017-05-26 Online:2017-07-15 Published:2017-07-15
  • Contact: Pei-xun Zhang, Ph.D., zhangpeixun@bjmu.edu.cn.
  • Supported by:

    This research was supported by a grant from the Ministry of Science and Technology 973 Project Planning of China, No. 2014CB542201; a grant from National High-Technology Research and Development Program of China (863 Program), No. SS2015AA020501; the National Natural Science Foundation of China, No. 31571235, 31571236, 31271284, 31171150; a grant from the Ministry of Education Innovation Team of China, No. IRT1201; the Educational Ministry New Century Excellent Talents Support Project of China, No. BMU20110270; a grant from the Ministry of Health of the Public Welfare Industry Special Scientific Research of China, No. 201302007.

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摘要：

总所周知，运动神经和感觉神经的传导方式和传导方向是不同的，所以在手术中，如果有需要，应该尽可能将运动神经和感觉神经区分开并用束膜缝合法来修复神经以达到最好的预后效果。那么临床上常有错接的感觉-运动神经和运动-感觉神经又会发生怎样的变化？为了揭示以上问题，作者分析了大鼠股神经的解剖结构，发现其在股四头肌内侧分为2支，运动支和感觉支，而这2支神经的组成也恰好分别以这2种神经为主，而且粗细程度便于操作。所以将这2根神经切断，再用感觉神经的近端与运动神经的远端相连，来观察新生的感觉神经纤维的变化。然后以乙酰胆碱酯酶染色明确区分有髓与无髓、运动与感觉的部分；并从组织形态学、电生理学、组织化学3个方面对去神经的肌肉和新生神经进行比较。神经导管连接后8周神经导管两侧均未见运动神经纤维，且近端神经纤维数量增加，导管两侧新生不同类型神经纤维的比例存在差异。近端再生神经中自主神经面积较低，而远端神经无明显髓鞘。结果证明了感觉神经与运动神经不能进行有效的连接，且远端效应器的改变影响了近端感觉神经纤维的再生类型。

ORCID:0000-0003-0929-6293(Pei-xun Zhang)

关键词: 神经再生, 神经寄养, 神经重构, 周围神经, 乙酰胆碱酯酶染色, 去神经的肌肉, 神经吻合, 神经导管

Abstract:

Motor nerves and sensory nerves conduct signals in different directions and function in different ways. In the surgical treatment of peripheral nerve injuries, the best prognosis is obtained by keeping the motor and sensory nerves separated and repairing the nerves using the suture method. However, the clinical consequences of connections between sensory and motor nerves currently remain unknown. In this study, we analyzed the anatomical structure of the rat femoral nerve, and observed the motor and sensory branches of the femoral nerve in the quadriceps femoris. After ligation of the nerves, the proximal end of the sensory nerve was connected with the distal end of the motor nerve, followed by observation of the changes in the newly-formed regenerated nerve fibers. Acetylcholinesterase staining was used to distinguish between the myelinated and unmyelinated motor and sensory nerves. Denervated muscle and newly formed nerves were compared in terms of morphology, electrophysiology and histochemistry. At 8 weeks after connection, no motor nerve fibers were observed on either side of the nerve conduit and the number of nerve fibers increased at the proximal end. The proportion of newly-formed motor and sensory fibers was different on both sides of the conduit. The area occupied by autonomic nerves in the proximal regenerative nerve was limited, but no distinct myelin sheath was visible in the distal nerve. These results confirm that sensory and motor nerves cannot be effectively connected. Moreover, the change of target organ at the distal end affects the type of nerves at the proximal end.

Key words: nerve regeneration, nerve remodeling, peripheral nerve, acetylcholinesterase staining, muscle denervation, neural anastomosis, nerve conduit, neural regeneration