胸廓出口综合征患者颈项部牵涉痛机制探讨——荧光素逆行双标法

Possible mechanism of referred pain around neck caused by thoracic outlet syndrome

目的 :应用荧光素逆行双标法 ,研究胸廓出口综合征患者 (tboracicoutletsyndrome ,TOS)颈项部牵涉痛的神经解剖学机制。方法 :8只Wistar大鼠 ,用荧光素逆行双标法 ,将荧光素快蓝 (FB)注入颈椎关节突关节周围 ,核黄 (NY)于近椎间孔处注入C5神经前支外膜下 ,观察颈部DRG中标记细胞。结果 :在颈部的C5、C6DRG中发现荧光素双标细胞以及两种单标细胞 ,以中小细胞为主。结论 :颈部的背根神经节细胞周围突有分支投射到颈椎关节突关节及C5前支 ,提示TOS患者颈项部疼痛的发生机制可能与DRG中感觉神经元周围突分支有关。

Objective:To clucidate the mechanism of referred pain around neck c aused by thoracic outlet syndrome using retrograde fluorescent labeling.Methods: Eight SD rats were observed by the retrograde fluorescent double labeling.Fast B lue (FB) was injected into the muscles around neck and Nuclear Yellow into C 5 ne rve root.The fluorescent double-labeled cells were observed in cervical dorsal root ganglia (DRG).Results:The fluorescent double-labe led cells were found in cervical dorsal root ganglia,especially in C 5 and C 6 DRG,and most of the labe led cells were small or medial in size.Conclusions:The r esult indicates that the peripheral process of cervical DRG cells dichotomize to the neck muscles and sho ulder joint.Therefore,the referred pain around neck induced by thoracic outlet s yndrome may be caused by axis reflex in the peripheral process of DRG cells.