中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (2): 306-312.doi: 10.4103/1673-5374.244802

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

源性自动神经放电促进神经修复：进一步优化动物模型

  

  • 出版日期:2019-02-15 发布日期:2019-02-15
  • 基金资助:

    国家自然科学基金资助项目，编号：81501051，81572127；复旦大学华山医院科研项目，编号：2013QD05

Endogenous automatic nerve discharge promotesnerve repair: an optimized animal model

 Jing Rui 1, 2 , Ying-Jie Zhou 1 , Xin Zhao 1 , Ji-Feng Li 2, 3 , Yu-Dong Gu 1, 2 , Jie Lao 1, 3   

  1. 1 Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
    2 Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
    3 Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
  • Online:2019-02-15 Published:2019-02-15
  • Contact: Jie Lao, MD, PhD, laojie633@sina.com.
  • Supported by:

    This study was supported by the National Natural Science Foundation of China, No. 81501051 (to JR), 81572127 (to JL); the Scientific Research Project of Huashan Hospital of Fudan University of China, No. 2013QD05 (to JR).

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摘要：

有研究表明外源性的电刺激（例如神经电刺激仪）对神经再生有明显促进作用。课题组以往研究结果也表明膈神经、肋间神经的内源性神经电刺激对神经再生早期（术后1个月）有促进作用，但在神经再生中期（术后2个月）因为瘢痕卡压而有抑制作用。为了解除中期瘢痕卡压的抑制作用，我们设计了4种神经损伤修复模型大鼠，对照组为锁骨下肌皮神经切断直接修复，其他3组在此基础上分别增加膈神经(PN)组、肋间神经(ICN)组及胸背神经(TDN)组通过自体腓肠神经移植与肌皮神经吻合口的远端进行侧侧吻合，以避免3个神经吻合在一起而造成的吻合口瘢痕卡压。术后通过检测肌皮神经电生理、二头肌肌张力、肌湿质量、肌肉最大横切面积和肌皮神经吻合口近端、远端及移植中段有髓神经纤维计数参数对肌皮神经再生进行检测。(1)在术后1个月，PN组和ICN组二头肌的复合肌肉动作电位的波幅明显高于对照组；PN组和ICN组肌皮神经吻合口远端的有髓神经纤维计数明显高于对照组和TDN组；TDN组移植神经中段的神经髓鞘变性率，明显高于PN组和ICN组；(2)在术后2，3个月时，4组上述各检测指标差异无显著性意义；(3)上述数据说明，实验针对内源性自动神经放电促进神经修复，建立了更优化的动物模型，将移植神经吻合至原吻合口远端可以避免3个神经吻合在一起而造成的吻合口瘢痕卡压。

orcid: 0000-0003-4343-6050(Jie Lao)

关键词: 周围神经损伤, 内源性自主放电, 神经侧-侧吻合, 膈神经, 肋间神经, 动物模型, 电治疗, 大鼠, 神经卡压, 周围神经再生, 神经再生

Abstract:

Exogenous electrical nerve stimulation has been reported to promote nerve regeneration. Our previous study has suggested that en¬dogenous automatic nerve discharge of the phrenic nerve and intercostal nerve has a positive effect on nerve regeneration at 1 month postoperatively, but a negative effect at 2 months postoperatively, which may be caused by scar compression. In this study, we designed four different rat models to avoid the negative effect from scar compression. The control group received musculocutaneous nerve cut and repair. The other three groups were subjected to side-to-side transfer of either the phrenic (phrenic nerve group), intercostal (intercostal nerve group) or thoracodorsal nerves (thoracic dorsal nerve group), with sural nerve autograft distal to the anastomosis site. Muscu¬locutaneous nerve regeneration was assessed by electrophysiology of the musculocutaneous nerve, muscle tension, muscle wet weight, maximum cross-sectional area of biceps, and myelinated fiber numbers of the proximal and distal ends of the anastomosis site of the mus¬culocutaneous nerve and the middle of the nerve graft. At 1 month postoperatively, compound muscle action potential amplitude of the biceps in the phrenic nerve group and the intercostal nerve group was statistically higher than that in the control group. The myelinated nerve fiber numbers in the distal end of the musculocutaneous nerve and nerve graft anastomosis in the phrenic nerve and the intercos¬tal nerve groups were statistically higher than those in the control and thoracic dorsal nerve groups. The neural degeneration rate in the middle of the nerve graft in the thoracic dorsal nerve group was statistically higher than that in the phrenic nerve and the intercostal nerve groups. At 2 and 3 months postoperatively, no significant difference was detected between the groups in all the assessments. These findings confirm that the phrenic nerve and intercostal nerve have a positive effect on nerve regeneration at the early stage of recovery. This study established an optimized animal model in which suturing the nerve graft to the distal site of the musculocutaneous nerve anastomosis pre¬vented the inhibition of recovery from scar compression.

Key words: nerve regeneration, peripheral nerve regeneration, endogenous automatic discharge, side-to-side nerve anastomosis, phrenic nerve, intercostal nerve, animal model, electrical treatment, rats, nerve compression, neural regeneration