失神经支配骨骼肌的萎缩机制

Mechanism of skeletal muscle atrophy due to denervation

目的:探索失神经支配骨骼肌萎缩的机制已经成为21世纪周围神经领域内的重要任务和研究热点。就血管床重塑、肌细胞凋亡、肌卫星细胞耗竭及成肌因子调控等四个方面对该领域做一归纳。资料来源:应用计算机检索Medline数据库1990-01/2005-01期间的相关文章,检索词为“denervation,muscle atrophy,histology,ultrastructure,motorend-plate,RT-PCRMyoD,myogenin,myostatin,immunohistochemistry,apoptosis”,限定文章语言种类为英文。同时计算机检索中国期刊全文数据库1990-01/2005-01期间的相关文章,检索词“失神经,肌萎缩,形态学,运动终板,超微结构,免疫组化,凋亡”,限定文章语言种类为中文。资料选择:对约330篇文献资料进行初审,纳入研究失神经支配骨骼肌萎缩机制的文献;随机、对照和盲法等论证推荐的文章。排除综述类及重复研究。资料提炼:共收到50余篇关于失神经支配骨骼肌萎缩机制的相关文章。排除20篇综述类及重复研究,对符合标准的27篇文献进行分析。资料综合:失神经支配骨骼肌萎缩机制的研究是多角度、多方面的。血管床重塑、肌细胞凋亡、肌卫星细胞耗竭及成肌因子调控等都是其中重要的作用因素。目前仍不能明确在整个失神经肌萎缩的发生中,是各种因素共同起作用,还是其中哪种因素起主导作用,抑或还有别的什么因素,这些尚待深入研究。结论:血管床重塑、肌细胞凋亡、肌卫星细胞耗竭及成肌因子调控等是骨骼肌失神经支配以后发生萎缩的重要机制。

OBJECTIVE： Investigation in the mechanism of denervation skeletal muscle atrophy has been a hot issue in researches of 21 Century on peripheral nerve. To summarize from four aspects： Remodeling of vascular bed, the apoptosis of myocytes, the exhausting of satellite cells and the regulation of myogenin. DATA SOURCES： A computer based online search of Medline for relevant articles published be .tween January 1990 and January 2005 was performed using the key words of ＂denervation, muscle atrophy, histology, ultrastructure, motor end-plate, TR-PCR, MyoD, myogenin, myostatin, immunohistochemistry, apoptosis＂, and the language was limited to English. Meanwhile, CNKI was searched for relevant literatures between January 1990 and January 2005 with the key words of ＂denervation, muscle atrophy, histology, motor end-plate, ultrastructure, immunohistochemistry, apoptosis＂ in Chinese. STUDY SELECTION： About 330 literatures were checked in the first trial, and literatures on the mechanism of muscle atrophy due to denervation, and randomized, controlled and blind trials were included. Repetitive studies and reviews were excluded. DATA EXTRACTION： More than 50 articles related to the mechanism of denervation muscle atrophy were collected, and 20 reviews and DATA SYNTHESIS： Research on the mechanism of denervation muscle atrophy is from multiple angels and aspects. Remodeling of vascular bed, the apoptosis of myocytes, the exhausting of satellite cells and the regulation of myogenin were important influential factors. However, in denervation muscle atrophy, it is of a cooperative action from all factors or only from some factor, or there are some other factors are not clear. Therefore, more work must be done to further the study. CONCLUSION： Remodeling of vascular bed, the apoptosis of myocytes, the exhausting of satellite cells and the regulation of myogenin are important to the muscle atrophy due to denervation.