甲钴胺治疗非压迫性腰椎间盘突出症的实验研究

Effects of methylcobalamin on non-compressive nucleus pulposus protrusion in rats

目的在无机械压迫情况下,甲钴胺对大鼠自体髓核导致的神经根损伤有无修复作用。方法选择10月龄SD雄性大鼠24只,随机分成对照组、模型组、甲钴胺治疗组,每组8只。切开大鼠尾椎椎间盘,髓核呈胶冻样,取5个髓核并加入50μl生理盐水,充分搅拌稀释成混悬液备用,将混悬液注射到大鼠腰椎硬膜外腔制作动物模型。24只SD雄性大鼠随机分成对照组、模型组和甲钴胺干预组,分别将生理盐水、尾椎髓核混悬液注射到腰椎硬膜外腔,甲钴胺治疗组用甲钴胺(500μg/kg)注射液,每天腹腔内注射共20d。测定大鼠后肢机械刺激缩爪阈值和疼痛相关行为,20d后观察神经根的组织形态学变化。结果在无机械压迫情况下,硬膜外移植自体髓核能使大鼠后肢产生明显的痛觉过敏,神经根出现脱髓鞘改变;甲钴胺可以明显减轻大鼠的痛觉过敏,促进髓鞘再生。结论甲钴胺对自体髓核致神经根的脱髓鞘损伤有修复作用。

Objective To study whether methylcobalamin was a good drug used in the treatment of lumbar disc herniation without mechanical compression. Methods 24 male Sprague - Dawley （SD） rats were randomly divided into three groups： control group, model group and methylcobalamin treated group,8 rats in each group. Five coccygeal nucleus pulposus was taken out and added 50μl saline,fully diluted suspension. The suspension was transplanted to the epidural space of rats to establish the non -compressive model of experimental lumbar nucleus pulposus prolapsed. 24 SD male rats were randomly divided into control group, model group and methylcobalamin treated group. The saline and coccygeal nucleus pulposus suspension was respectively injected into lumbar epidural space. Methylcobalamin treated group,intraperitoneal injection of methylcobalamin （500 μg/Kg） each day for 20 days. The rat hind paw mechanical withdrawal thresholds were measured, pain - related behavior and lumbar nerve root morphology were observed. Results In the absence of mechanical pressure, demyelination of lumbar nerve root and significant hyperalgesia derived by auto - transplantation of nucleus pulposus to the epidural cavum of rats were observed. Methylcobalamin could significantly reduce hyperalgesia in rats,promoted nerve remyelination. Conclusion Methylcobalamin promotes nerve remyelination on non - compressed lumbar disc herniation.