失神经支配骨骼肌萎缩的生物学和组织学变化

Biological and histological changes of denervated skeletal muscular atrophy

目的:探讨失神经骨骼肌萎缩在电生理、组织病理学、生物化学和分子生物学方面的进展。资料来源:应用计算机检索Pubmed1990-01/2005-01的文章,检索词为“denervation,denervationmuscle,denervationmuscleatrophy,denervatedmuscle,nerveinjury,denervatedskeletalmuscle,skeletalmuscle,denervationatrophy”,限定文章语言种类为English。同时计算机检索万方数据库1995-01/2005-01期间的相关文献,并进行手工检索。资料选择:对资料进行初审,选取有关失神经支配骨骼肌方面的研究。纳入标准:①研究失神经支配后骨骼肌的病理生理等的改变方面。②失神经支配骨骼肌的基础研究和临床研究。排除标准:①防治失神经肌萎缩的研究内容。②重复研究。资料提炼:共收集到300篇关于骨骼肌失神经支配后的生理、病理、生化、分子生物学等方面的文章,入选40篇。资料综合:失神经骨骼肌在肌电图上呈正尖波。其表达上调的蛋白则可能与肌萎缩的发生过程有关。骨骼肌失神经支配时,三磷酸腺苷酶活性增高。骨骼肌失神经支配后神经终板肿胀、线粒体破坏及突触数量减少。失神经比目鱼肌出现细胞皱缩、核固缩、核周池扩大、染色质浓缩等细胞凋亡的形态学改变,但未发现明显核碎片。在失神经肌萎缩细胞凋亡的基因调控方面,Ⅱ型肌纤维的凋亡与Fas基因的表达有关,与Bcl-2基因无关。结论:骨骼肌失神经支配后发生一系列的复杂的变化,通过此研究可形成防治失神经支配骨骼肌萎缩的有效措施。

OBJECTIVE： To investigate the progression on denervated skeletal muscular atrophy in histopathology, biochemistry and molecular biology. DATA SOURCES： An computer-based online search of Pubmed database was undertaken to identify articles published in English between January 1990 and January 2005 by using the keywords of ＂denervation,denervation muscle,denervation muscle atrophy, denervated muscle, nerve injury, denervated skeletal muscle, skeletal muscle, denervation atrophy＂. Meanwhile, Chinese relevant articles published from January 1995 to January 2005 were searched with computer in Wanfang database, also retrieved manually. STUDY SELECTION： The data were checked flatly, the articles on denervated skeletal muscle were collected. Inclusive criteria： （1） the articles on physiological and pathological change of denervated skeletal muscle; （2） elementary and clinical investigation. Exclusive criteria：（1） prevention and cure of denervated skeletal muscular atrophy; （2） repetitive studies. DATA EXTRACTION： Totally 300 articles in all on denervated skeletal muscle in physiology, pathology, biochemistry, molecular biology were collected, of which 40 articles were selected. DATA SYNTHESIS： The denervated skeletal muscle assumes positive sharp wave on electromyogram. The proteinum of express up-regulation is possibly relevant with denervation muscle atrophy. In denervation muscle, ATPase activity raises up, nerve end plate swells, chondrosome destroys, synapsis diminishes, denervation soleus muscle appear apoptotic morphology change, such as cellule crenation, karyopycnosis, perinuclear cisterna dilatation, caryotin concentration, but not appear evident nuclear fragmentation. In gene regulation, Ⅱ-type muscle fiber＇ apoptosis is relevant to Fas expression, irrelevant to Bcl-2 expression. CONCLUSION： After denervation, skeletal muscle proceed serial complicated changes, and the investigation is beneficial to prevention and cure of denervated skeletal muscular atrophy.