不同剂量的糖皮质激素对复杂区域疼痛综合征1型大鼠骨折模型的治疗作用

Different-dosed glucocorticoid in treatment of tibial fracture rat model of complex regional pain syndrome type 1

目的探讨不同剂量的激素治疗复杂区域疼痛综合征1(complex regional pain syndrome type 1,CRPS1)大鼠的疗效及其对肿瘤坏死因子-α(TNF-α)、血清P物质(SP)、巨噬细胞游走抑制因子(microphage migration inhibitory factor,MIF)表达的影响。方法 30只成年雄性SD大鼠,随机数字表法分3组,每组10只:治疗1、2组、对照组在进行骨折制动造模结束后分别以甲强龙4、20 mg/(kg.d)和生理盐水对应治疗,腹腔注射,连续1周。治疗前后检测动物疼痛行为,治疗结束后8 h、1、3周检测血清SP、MIF及TNF-α水平。结果两治疗组在不同剂量激素治疗后,肢体肿胀、疼痛不同程度缓解。治疗2组血清SP、MIF、TNF-α均明显低于对照组(P<0.01,P<0.05),在各个观察点疼痛阈值均高于治疗1组及对照组(P<0.05)。结论大剂量的糖皮质激素对大鼠骨折CRPS1模型疗效优于小剂量,且对炎症因子有显著且持续抑制作用,小剂量糖皮质激素可部分缓解肢体肿胀及疼痛,对部分细胞因子表达有即时抑制作用。不同剂量激素在CRPS1型的疗效差异与其能否抑制MIF有关。

Objective To determine the efficacy and possible mechanism of glucocorticoid at different doses in complex regional pain syndrome type 1（CRPS1） rat model and its effect on serum P substance（SP）,macrophage migration inhibitory factor（MIF） and tumor necrosis factor alpha（TNF-α）.Methods Thirty adult health SD rats were randomly divided into control group,treatment-1 group and treatment-2 group with 10 rats in each group.Methylprednisolone（MP） was abdominally administered in treatment-1 group [4 mg/（kg·d）] and treatment-2 group [20 mg/（kg·d）].Pain behaviors were observed after 1-week-treatment.Serum SP,MIF and TNF-α were measured by ELISA at 8 h,1 and 3 weeks after 1-week-treatment.Results Hindpaw edema and pain was better after 1-week-treatment in 2 groups.T-2 group had higher pain threshold and lower serum levels of SP,MIF and TNF-α when compared to T-1 group and control group（P0.01,0.05）.Conclusion It is suggested high-dose glucocorticoid is more effective in releasing edema and pain in CRPS1 rat model than low-dose glucocorticoid.Glucocorticoid might be through instantly suppressing some inflammatory factors.The difference of different doses of glucocorticoid might be due to whether suppresses MIF.