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): 1177-1185.doi: 10.4103/1673-5374.211200

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

交感神经干切除后大鼠后肢交感神经功能可能比躯体恢复得更慢

  

  • 收稿日期:2017-05-20 出版日期:2017-07-15 发布日期:2017-07-15
  • 基金资助:

    国家自然科学基金（81171812，81272105，81671924）

Recovery of sympathetic nerve function after lumbar sympathectomy is slower in the hind limbs than in the torso

Zhi-fang Zheng1, 2, Yi-shu Liu2, 3, Xuan Min2, Jian-bing Tang2, Hong-wei Liu4, Biao Cheng1, 2, 3, 5, 6   

  1. 1 The Graduate School of Southern Medical University, Guangzhou, Guangdong Province, China; 2 Department of Plastic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong Province, China; 3 The Graduate School of Third Military Medical University, Chongqing, China; 4 Department of Plastic Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China; 5 Center of Wound Treatment, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong Province, China; 6 The Key Laboratory of Trauma Treatment & Tissue Repair of Tropical Area of Chinese PLA, Guangzhou, Guangdong Province, China
  • Received:2017-05-20 Online:2017-07-15 Published:2017-07-15
  • Contact: Biao Cheng, M.D., chengbiaocheng@163.com.
  • Supported by:

    This work was supported by the National Natural Science Foundation of China, No. 81171812, 81272105 and 81671924.

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摘要：

临床上交感神经切除可用于治疗下肢溃疡及缺血，造成躯体局部的交感神经失能，但皮肤交感神经失能后的恢复情况尚不清楚。实验设计切除大鼠双侧L2-4的交感干后观察皮肤交感神经功能的恢复规律。通过点温度计监测，发现大鼠腰交感干切除后左后足底皮肤温度升高。免疫荧光结果显示，神经元的细胞质酪氨酸羟化酶和多巴胺β羟化酶均呈阳性表达，证实了腰交感干切除的准确性。碘淀粉试验结果表明，交感神经切除后2、7周，大鼠后足足底皮肤发汗功能下降，到切除后3个月恢复正常。免疫组织化学和Western blot结果显示，交感神经切除后2周，大鼠骶尾部和后足的皮肤组织去甲肾上腺素和多巴胺β羟化酶表达下降。透射电镜结果显示，交感神经切除后3个月，大鼠L5交感神经干表现出神经元核周间隙增宽，轴突脱髓鞘改变。虽然腰交感神经切除后2周大鼠骶尾部和后足均出现了交感神经失能，但是切除后7周骶尾部皮肤交感功能恢复，切除后3个月后足部皮肤交感神经功能恢复。综合结果证明，皮肤交感神经功能的恢复可解释交感神经干切除后多汗症复发以及交感神经不完全损伤后的再生现象；交感神经干切除后后肢端的交感神经功能可能比躯体恢复得更慢。

ORCID:0000-0003-3383-1671(Biao Cheng)

关键词: 神经再生, 腰交感神经切除术, 交感神经, 皮肤, 交感神经失能, 交感神经再生, 皮肤温度, 碘和淀粉实验, 酪氨酸羟化酶, 去甲肾上腺素, 多巴胺β-羟化酶, 功能恢复

Abstract:

Local sympathetic denervation by surgical sympathectomy is used in the treatment of lower limb ulcers and ischemia, but the restoration of cutaneous sympathetic nerve functions is less clear. This study aims to explore the recovery of cutaneous sympathetic functions after bilateral L2–4 sympathectomy. The skin temperature of the left feet, using a point monitoring thermometer, increased intraoperatively after sympathectomy. The cytoplasm of sympathetic neurons contained tyrosine hydroxylase and dopamine β-hydroxylase, visualized by immunofluorescence, indicated the accuracy of sympathectomy. Iodine starch test results suggested that the sweating function of the hind feet plantar skin decreased 2 and 7 weeks after lumbar sympathectomy but had recovered by 3 months. Immunofluorescence and western blot assay results revealed that norepinephrine and dopamine β-hydroxylase expression in the skin from the sacrococcygeal region and hind feet decreased in the sympathectomized group at 2 weeks. Transmission electron microscopy results showed that perinuclear space and axon demyelination in sympathetic cells in the L5 sympathetic trunks were found in the sympathectomized group 3 months after sympathectomy. Although sympathetic denervation occurred in the sacrococcygeal region and hind feet skin 2 weeks after lumbar sympathectomy, the skin functions recovered gradually over 7 weeks to 3 months. In conclusion, sympathetic functional recovery may account for the recurrence of hyperhidrosis after sympathectomy and the normalization of sympathetic nerve trunks after incomplete injury. The recovery of sympathetic nerve function was slower in the limbs than in the torso after bilateral L2–4 sympathectomy.

Key words: nerve regeneration, lumbar sympathectomy, sympathetic nerve, skin, recovery of function, neural regeneration