采用预防性甲基强的松龙保护脊髓损伤的最佳时间和剂量

Timing and dosage:neuroprotective effect of high-dose methylprednisolone preventively in rat acute spinal cord injury

目的研究预防性使用大剂量甲基强的松龙保护急性脊髓损伤大鼠神经功能的最佳时间和剂量。方法96只SD大鼠按析因设计随机分为16组,甲基强的松龙的使用剂量分别为:15mg/kg、30mg/kg、60mg/kg、120mg/kg;使用时间分别在脊髓打击前:0min、15min、30min、60min。在脊髓损伤后72小时,进行Tarlov评分、Molt斜板功能评分和运动诱发电位检测。结果在Tarlov评分障碍率上,预防性使用甲基强的松龙30mg/kg组效果明显;在Molt斜板功能障碍率、运动诱发电位上,预防性使用甲基强的松龙30mg/kg、60mg/kg组均有效果,而预防性使用甲基强的松龙的使用时间则影响不大。综合以上指标,在15min～30min范围内使用较好。其中,又以提前30min使用,效果最明显。结论30mg/kg、60mg/kg的甲基强的松龙对脊髓损伤有神经保护作用,但以30mg/kg效果更明显。在脊髓损伤前15min～30min范围内使用甲基强的松龙较好。其中,30mg/kg体重的甲基强的松龙在脊髓损伤前30min静脉推注对脊髓损伤大鼠神经功能的预防保护作用更好。

Objective To find out the better time and dosage of administration of high-dose methylprednisolone in prophylaxis in acute spinal cord injury rats. Methods Ninety-six healthy SD rats were randomly divided into sixteen groups according to factor analysis,dosage of methylprednisolone： 15mg/kg,30mg/kg,60mg/kg,120mg/kg;timing of administration：0min,15 min,30min,60min. Allen＇s weight drop model of acute spinal cord injury was prepared. Methylprednisolone was administrated through caudal vein before beat as formerly described. Tarlov＇s motor scales,Molt＇s inclined plane scales and motor evoked potentials at 72-hour after SCI were respectively studied. Results MP group of 30mg/kg showed significantly neurological effects on SCI according to Tarlov＇ s motor scales. MP groups of 30mg/kg and 60mg/kg showed significantly neurological effects on SCI according to Moh＇s inclined plane scales and motor evoked potentials. From the administration time of MP,it was better at 15min and 30min before SCI. And it showed that administration at 30min before SCI was the best. Conclusion MP groups of 30mg/kg and 60mg/kg had significantly neurological effects on SCI and MP group of 30mg/kg was better. From the administration time of MP,it was better at 15min and 30min before SCI. Administration of 30mg/kg MP at 30min before SCI was the best among these groups.