面神经损伤后钙泵活性变化与面肌功能恢复的关系

Relationship between changes of calcium pump activity and functional recovery of facial muscles after injury of facial nerve

目的:探讨不同程度面神经失神经支配后口轮匝肌(简称:口肌)肌纤维钙泵活性的变化与面肌功能恢复的关系。方法:60只豚鼠,随机分为压榨5s(n=15),压榨15s(n=20),压榨30s(n=25)3组,制造面神经麻痹模型,应用神经电图测试压榨面神经前后阈值,观察恢复到压榨前阈值的时间;并应用瞬目反射观察面肌功能恢复时间。取口肌进行Ca2+-ATP酶细胞化学染色透射电镜下观察钙泵活性的变化。结果:压榨5s组的平均神经兴奋传导抑制时间为(35.1±16.6)min;肌纤维钙泵活性正常。压榨15s组瞬目反射恢复正常平均需(48±15)d,15d时钙泵活性轻度下降,30d时钙泵活性基本恢复正常。压榨30s组15d和30d时肌纤维钙泵活性重度降低,半年内瞬目反射无一只恢复。结论:面神经受损伤持续时间越长肌功能受损伤程度越重,康复越难,应早期行面神经减压术。

AIM:To study the relationship between the changes of calcium(Ca) pump activity of orbicularis oris muscle fiber and the functional rehabilitation of facial muscles after different level of facial nerve denervation. METHODS:Sixty guinea pigs were randomly divided into 5 s squeezed group(n=15),15 s squeezed group(n=20) and 30 s squeezed group(n=25).Models of facial paralysis were established.The threshold of facial nerve was detected with electroneurogram before and after being squeezed,the duration it spent in recovering to the threshold value before being squeezed was recorded,and the duration of the functional recovery of facial muscles was observed by using blink reflex.Orbicularis oris muscles were taken to perform Ca2+-ATPase cytochemical staining,and the changes of Ca pump activity were observed under transmission electroscope. RESULTS:In the 5 s squeezed group,the average inhibition time of stimulation conduction was(35.1±16.6) minutes, and the Ca pump activity of muscle fibers was normal.In the 15 s squeezed group,the mean duration of recovery to the normal blink reflex was(48±15) days,and the Ca pump activity decreased slightly after 15 days and almost recovered to the normal after 30 days.In the 30 s squeezed group,the Ca pump activity of muscle fibers still decreased severely after 30 days.None of them recovered blink reflex within half a year. CONCLUSION:The longer the facial nerve has been injured,the severer the injury of muscular function is,the more difficult the rehabilitation is,so facial nerve decompression should be applied as early as possible.