直流电场与甲基强的松龙联合应用促进脊髓再生的实验研究(英文)

Combination of direct current electric field and methylprednisolone in promoting spinal cord regeneration

背景:直流电场能促进脊髓再生,但伤后6h置入电刺激器的疗效比伤后立即置入电刺激器的疗效为差,可能于脊髓损伤后出现脊髓水肿有关。目的:探讨直流电场与大剂量甲基强的松龙联合应用治疗完全性脊髓损伤的疗效。设计:随机对照实验。地点和对象:实验在海南省人民医院完成。对象为33只中国家犬,体质量10～12kg,犬龄1.5～2岁,由海南省动物中心提供。干预:将33只家犬随机分成3组,用AllenWD法致脊髓完全损伤。A组为对照组;B组脊髓损伤6h时置入电刺激器组;C组脊髓损伤2h静滴大剂量甲基强的松龙,脊髓损伤6h再置入电刺激器组。主要观察指标:伤后各组1,2,3个月神经功能、皮层体感诱发电位、神经元数量、神经元截面积和内氏体密度恢复情况。结果:神经功能评分:A组伤后1～3个月均为1分;B组伤后个月13分,伤后2,3个月均为4分;C组伤后1个月4分,伤后2,3个月均为5分。B,C组1,2,3个月神经功能、皮层体感诱发电位、神经元数量、神经元截面积和尼氏体密度恢复均优于同时期组(PA<0.05或P<0.01)。此外,C组优于组,差异有显著性意义。B结论:直流电场能有效地促进脊髓再生,直流电场与大剂量甲基强的松龙联合应用能有效地协同治疗脊髓损伤,特别是促进神经功能早期更好的恢复。

BACKGROUND:Direct current electric field can promote the regeneration of the spinal cord.However,implanting the electric stimulator into the body at 6 hours after spinal cord injury(SCI) is less effective than implanting it immediately after SCI.It may be associated with the spinal cord edema after SCI. OBJECTIVE:To explore the effectiveness of combining direct current electric field with large dose methylprednisolone(MP) in treating complete SCI. DESIGN:A completely randomized controlled study was conducted. SETTING and PARTICIPANTS:The study was completed in People's Hospital of Hainan Province.A total of 33 healthy Chinese dogs,weighing 10 to 12 kg and aged 1.5 to 2 years,were obtained from Center for Experimental Animals of Hainan Province. INTERVENTIONS:The 33 dogs were randomly divided into three groups and complete SCI was induced on them with Allen WD method.Group A was control group;group B was implanted with the electrical stimulator into the body at 6 hours after SCI;group C was injected with large dose of MP at 2 hours after injury and the electrical stimulator was implanted into the body at 6 hours after injury. MAIN OUTCOME MEASURES:Nerve function,cortical somatosensory evoked potential(CSEP),the number of neurons,sectional area of neurons and density of Nissl bodies were observed 1,2 and 3 months after injury. RESULTS:Nerve function grading:In group A it was all grade 1 at 1 to 3 months postoperatively.In group B it was grade 3 after 1 month,and grade 4 at 2 to 3 months.In group C it was grade 4 after 1 month,and was grade 5 after 2 to 3 months.The indexes of nerve function,CSEP,the number of neurons,sectional area of neurons,and density of Nissl bodies in groups B and C were all better than those in group A(P< 0.05 or P< 0.01).Moreover,those indexes in group B were significantly better than those in group C. CONCLUSION:Direct current electric field can effectively promote spinal cord regeneration.The combination of direct current electric field withlarge dose MP has synergistic effects in treating SCI,particularly accelerating recovery of nerve function.