用运动诱发电位评价急性脊髓损伤的治疗效果(英文)

Assessment of motor evoked potential for therapeutic effects in acute spinal cord injury

目的探讨运动诱发电位对脊髓损伤疗效的评价作用。方法健康雄性猫３２只，随机分为对照组、脊髓损伤组、治疗组和假治疗组，每组８只。采用Ａｌｅｎ’ｓ重量降落冲击法制备脊髓损伤模型，用ＮｅｕｒｏｐａｃｋⅡＭＥＢ５１００型诱发电位记录仪测各组动物的运动诱发电位。直接刺激大脑皮层运动区，记录电极位于腰椎棘突间。分别测试手术前、后、损伤后立即、损伤后３０、６０、９０、１２０ｍｉｎ的运动诱发电位。采用硫代巴比妥酸法测脊髓组织中反映自由基水平的指标之一丙二醛含量。治疗组动物于致伤后立即静脉输入超氧化物歧化酶，假治疗组则给于等量的生理盐水。结果损伤组动物ＭＥＰ呈进行性恶化，损伤处脊髓组织中丙二醛含量较对照组明显升高。治疗组动物ＭＥＰ较损伤组和假治疗组有改善，尤以伤后３０ｍｉｎ和６０ｍｉｎ为明显，而后逐渐恶化，其致伤脊髓组织中丙二醛含量也较上二组明显降低而接近正常对照组。治疗组动物病理结果亦较损伤组和假治疗组有改善。结论ＳＯＤ具有保护损伤脊髓组织的作用。ＭＥＰ可以做为评价脊髓损伤后治疗效果的客观指标。

Objective The purpose of this experiment was to research the protec-tive effect of superoxide dismutase (SOD) for injured spinal cord tissue and to evaluate the value of motor evoked potential ( MEP) for therapeutic effects in acute spinal cord injury(SCI). Methods Thirty two healthy male cats was randomly divided into four groups,including control group, injuried group,treated group and shamtreated group. The SCI animal models were established by Allen's method,cerebral cortical motor area was stimulated directly by pin-shaped electrode. MEP was measured before and after injuries immediately and 30 min, 60 min, and 120 min after injuries respectively, SOD (2.5mg·kg-1, iv)was given immediately after injury. The malonydialdelyde(MDA) levels of injured spinal cord tissue were measured with TBA method,and the histopathological examination was performed with microscopy in all groups.Results The MEP appeared progressive deterioration in animals with spinal cord injury and improved significantly in treated group than injured group and shamtreated group at 30 min and 60 min after spinal cord injury. The MDA levels of injured spinal cord tissue in treated group(25.95nmol·mg-1) were lower than injured group (35.80 nmol·mg-1) and shamtreated group(34.39nmol·mg-1)(P<0.001). The histopathological changes in treated group were improved significantly compared with injured group and shamtreated group.Conclusion The SOD may protect injured spinal cord tissue and MEP is able to be used as an objective standard to evaluate therapeutic effects in acute spinal cord injury.