白细胞介素6受体拮抗剂对大鼠脊髓水肿的作用(英文)

Effect of receptor antagonist of interleukin-6 on edema of spinal cord

背景:研究发现在脊髓损伤及感染过程中血液内白细胞介素6发生变化,进一步研究还发现白细胞介素6参与了脊髓损害过程。推测白细胞介素6与这些神经系统疾病伴发的脊髓水肿存在着关联。目的:观察白细胞介素6受体拮抗剂对外伤性脊髓水肿的影响,探讨白细胞介素6在外伤性脊髓水肿中的作用。设计:随机对照动物实验。单位:广东医学院附属医院骨科。材料:实验于2004-01/12在广东医学院实验动物中心完成,选择雄性Wistar大鼠40只,随机分为正常组、创伤组、生理盐水对照组及白细胞介素6受体拮抗剂治疗组,每组10只。方法:①白细胞介素6受体拮抗剂治疗组:液压冲击伤致胸部脊髓水肿,损伤区用微量注射器注入白细胞介素6受体拮抗剂。②创伤组:无上述置管、给药步骤。③生理盐水对照组:白细胞介素6换成无菌生理盐水,余步骤同白细胞介素6受体拮抗剂治疗组。④正常组:不作处理。各组大鼠于伤后24h进行磁共振检查,干湿重法测定脊髓含水量,苏木精-伊红染色病理图像分析及电镜观察大鼠脊髓水肿情况。主要观察指标:①各组大鼠磁共振检查结果。②各组大鼠脊髓含水量。③病理图像分析及电镜观察大鼠脊髓水肿情况。结果:40只大鼠均进入结果分析。①白细胞介素6受体拮抗剂治疗组与创伤组、生理盐水对照组相比T2加权像上水肿减轻。②生理盐水对照组、白细胞介素6受体拮抗剂治疗组、创伤组脊髓损伤区含水量较正常对照组高[(81.68±1.39)%,(79.72±1.49)%,(82.59±1.12)%,(77.19±0.64)%,P<0.01]。创伤组脊髓损伤区含水量较正常对照组高(P<0.01);白细胞介素6受体拮抗剂治疗组较创伤组低(P<0.01)。③创伤组灰质胞体收缩、细胞周围间隙加大,并有神经元丢失;生理盐水对照组与创伤组比较无明显差异;白细胞介素6受体拮抗剂治疗组细胞水肿、变性、坏死较创伤组轻。结论:白细胞介素6受体拮抗剂对于外伤性脊髓水肿有治疗作用,内源性白细胞介素6参与了外伤性脊髓水肿的发生。

BACKGROUND： Researches indicate that interleukin-6 （IL-6） in blood has changed during the process of the edema and infection of spinal cord. It is found that IL-6 participates in the course of spinal cord lesion according to the further researches. It is also presumed that the IL-6 is correlated with the edema of spinal cord accompanied nervous system diseases. OBJECTIVE： To observe the effect of the receptor antagonist of the IL-6 on the traumatic edema of spinal cord, and explore the effect of IL-6 in the process of the edema of spinal cord. DESIGN： Randomized control experiment with animals as subjects. SETTING： Department of Orthopedic, Hospital Affiliated to Guangdong Medical College. MATERIALS： The experiment was completed from January to December 2004 in the Animal Experimental Center of Guangdong Medical College. Forty male Wistar rats were selected and randomly divided into the normal group, the wound group, the saline control group and the receptor antagonist of the IL-6 treated group with 10 rats in each group. METHODS： ① The receptor antagonist of the IL-6 treated group： Blast injury of the thoracic spinal cord was made by the sap pressure, and the injection with the receptor antagonist of the IL-6 was given at the injured region with microinjector. ② The wound group： There was not the procedure of administration and placement of the tube. ③ The saline control group： The IL-6 was replaced with the sterile-physiological saline solution （SPSS）, and the other procedures were the same as those of the receptor antagonist of the IL-6 treated group. ④ The normal group： There was not any treatment. All rats in each group were detected with magnetic resonance. The water content in the spinal cord was determined with the dry and humid weight method, and the status of the edema of spinal cord was observed with the electron microscope and the pathological image analysis after dyeing with hematine-eosine. MAIN OUTCOME MEASURES： ① The results of the examination of the rats in each group with the magnetic resonance. ② The water content in the spinal cord of rats in each group. ③ The status of the edema of spinal cord was observed with the electron microscope and the pathological image analysis. RESULTS： All the 40 rats entered the result analysis. ① The edema of the T2 weighting image in the receptor antagonist of the IL-6 treated group was relieved as compared with that in the wound group and the saline control group. ② The water content of the injured region in the receptor antagonist of the IL-6 treated group, the wound group and the saline control group was higher than that in the normal group [（81.68±1.39）%, （79.72±1.49）%, （82.59±1.12）%, （77.19±0.64）% ,P 〈 0.01 ]. The water content of the injured region in the wound group was higher than that in the normal group（P 〈 0.01）, and the receptor antagonist of the IL-6 treated group was lower than that of the wound group （P 〈 0.01）. ③ The cell body of the gray substance was contracted, the inter-space around the cell was enlarged and the nerve cells were lost in the wound group; The saline control group was not significantly different as compared with the wound group; The cellular edema, degeneration and the necrosis in the receptor antagonist of the IL-6 treated group was milder than that in the wound group. CONCLUSION： The receptor antagonist of the IL-6 has the therapeutical effect on the traumatic edema of spinal cord. The endogenous IL-6 participates in the development of the traumatic edema of spinal cord.