复杂区域疼痛综合征1型的两种大鼠造模方法的比较

Comparison of two methods for establishing rat models of complex regional pain syndrome type 1

目的分析国外报道的两种复杂区域疼痛综合征1型的大鼠造模方法,比较造模后大鼠的疼痛行为、皮肤、神经组织结构改变、皮肤微循环以及血清P物质的变化。方法成年SD健康大鼠24只,随机分为假手术组,骨折制动组及缺血加压组,每组8只。所有大鼠造模前采血及测定疼痛阈值基线。假手术组给以石膏固定。骨折制动组采用胫骨骨折弹力绷带制动石膏固定模型,缺血加压组给以O形橡胶圈加压模型分别造模。造模结束后分别在8 h,24 h,48 h,4 d,1周,2周,4周时测定疼痛行为。并于造模结束后8 h、1周、2周、4周采血测定血清P物质的表达。结果骨折制动组有3只出现断肢,所剩5只造模8 h后均出现疼痛阈值下降。缺血加压组造模后8 h疼痛阈值下降较骨折制动组更为明显。血清P物质水平变化在两造模组基本同步。与对照组比较,骨折制动组与缺血加压组均有明显的皮肤微循环改变,以骨折制动组更为明显,骨折制动组大鼠皮肤病理结构无明显异常,部分可见小溃疡样改变。坐骨神经HE染色未见明显结构异常。结论骨折后制动石膏固定造模与缺血加压造模方法均可造成与复杂性局域疼痛综合征1型相似的疼痛,但骨折制动可造成更为持续的症状及病理改变。

Objective To investigate the difference between two methods for establishing rat models of complex regional pain syndrome type 1.Methods Twenty-four adult SD rats were randomly allocated into control group,tibia fracture group and ischemia group（n=8）,and complex regional pain syndrome type 1 was simulated in the latter two groups using different methods.The pain behaviors of the rats were observed and serum substance P level was detected with ELISA at different time points after the operations.Results Limb loss occurred in 3 rats in tibia fracture group,and the other 5 rats showed a lowered pain threshold.At 8 h after modeling,the rats in ischemia group showed more obvious reduction of pain threshold than those in tibia fracture group.Serum substance P levels in the two model groups underwent similar alterations after modeling,both significantly higher than that in the control group（P0.01）.Microcirculation changes were more serious in tibia fracture group than in ischemia group.Ulcer-like lesions were found in the skin of some rats in tibia fracture group.No obvious pathologies were observed microscopically in the sciatic nerve in the two model groups.Conclusion The two methods can both be effective to simulate complex regional pain syndrome type 1,but tibia fracture results in more sustained symptoms and pathological changes in the microcirculation.