模拟膈神经脉冲电刺激促进周围神经再生的研究

A study of promoting regeneration of peripheral nerve with simulated bioelectrical impulse of phrenic nerve

目的 研究膈神经生物电脉冲 (BIPN)对周围神经再生的促进作用。方法 新西兰家兔 18只平均分为 3组 ,切断双侧坐骨神经后端端缝合予以电刺激。A组以BIPN刺激与无刺激对照 ;B组以BIPN刺激与方波脉冲刺激对照 ;C组以方波脉冲刺激与无刺激对照。刺激 4周后行足底溃疡直径、神经电生理、胫前肌肌湿重、组织学和电镜超微结构检测。结果 A、B组BIPN侧足底溃疡直径分别为 (16.3 3± 17.17)mm和 (2 2 .3 3± 7.5 0 )mm ,均优于对照侧 (P <0 .0 1,P <0 .0 5 ) ;复合肌肉诱发电位 (CMAP)潜伏期分别为 (1.98± 0 .2 0 )ms和 (1.92± 0 .16)ms ,均优于对照侧 (P <0 .0 5 ) ;A组CMAP波幅为 (0 .18± 0 .0 7)mV ,优于对照侧 (P <0 .0 5 ) ;远端有髓纤维通过率分别为 (62 .44± 6.68) %和 (5 4.48± 5 .0 5 ) % ,均优于对照侧 (P <0 .0 1) ;胫前肌肌湿重分别为(1.67± 0 .2 4)g和 (1.71± 0 .2 5 )g ,均优于对照侧 (P <0 .0 1) ;超微结构观察示BIPN侧再生髓鞘成熟度优于方波脉冲侧 ,更优于无刺激侧。结论 膈神经电脉冲能较明显地促进周围神经再生。

Objective To study the effect of bioelectrical impulse of phrenic nerve (BIPN) on regeneration of peripheral nerve.Methods Eighteen New Zealand rabbits were divided into 3 groups (n= 6 in each group) after their bilateral sciatic nerves had been cut and then stitched in an end-to-end fashion.BIPN was compared with non-stimulation in group A,BIPN with square-wave in group B,and square-wave with non-stimulation in group C.After having been stimulated for 4 weeks,diameters of foot ulcer,latency and wave of CMAP,wet weight of anterior tibial muscle,histomorphometric and ultra structural observation were analyzed.Results Diameters of foot ulcer on BIPN sides of groups A and B were (16.33± 17.17) mm and (22.33± 7.50) mm,superior to those on the control sides (P< 0.01, P< 0.05); The latencies of CMAP were (1.98± 0.20) ms and (1.92± 0.16) ms,superior to those on the control sides (P< 0.05); The wave of CMAP in group A was (0.18± 0.07) mV,superior to that on the control side (P< 0.05); The passing-rates of myelinated fibers were (62.44± 6.68)% and (54.48± 5.05)% respectively,superior to those on the control sides (P< 0.01); The wet weight of tibial muscles was (1.67± 0.24) g and (1.71± 0.25) g,superior to that on the control sides (P< 0.01); Ultrastructural observation showed that the maturity of regenerated myelinated fibers stimulated by BIPN was superior to that stimulated by square-wave,and much more superior to non-stimulated side.Conclusion The bioelectrical impulse of phrenic nerve can improve the regeneration of peripheral nerves obviously.