慢性骨筋膜室综合征动物模型的建立及骨骼肌病理变化的实验研究

Experiment study on the pathogenesis of chronic compartment

目的探讨慢性骨筋膜室综合征所致比目鱼肌(红肌)、伸趾长肌(白肌)的病理变化。方法90只日本白兔分成15组。他们的右小腿被小儿充气式血压计袖带间断性、重复性的压迫。结果在40mmHg压力1d和3d压迫组中,骨骼肌细胞呈现炎性水肿和细胞直径增加。在80和120mmHg压力3d压迫组及40mmHg压力7、14和28d压迫组中,可见少量的坏死和有中性核细胞浸润的骨骼肌细胞,表明了早期细胞坏死。然而,在80和120mmHg压力7、14和28d压迫组中,骨骼肌细胞表明了显著的变性改变。这种改变是在压力较高组以及比目鱼肌比伸趾长肌更显著。结论重复性压迫可引起严重的骨骼肌组织的变性,特别是红肌。

Objective To elucidate the pathogenesis of chronic compartment syndrome, we examined pathological changes in the soleus (red) and extensor digitorum longus (EDL: white) muscles in Japanese white rabbits after repeated compression with a pneumatic tourniquet. Method Repeated tourniquet compression via cuff inflation was carried out on the rabbits, calves daily, for 2 hours, then stopped for 30 min, and then applied for another 2 hours. The contralateral hindlimb, with was not compressed, served as a control. Animals were allocated to 15 groups, with pressure of 40, 80, and 120 mmHg for periods of 1 day, 3 days, 1 week, 2 weeks, and 4 weeks. Skeletal muscle specimens in each group were studied by histopathological and histochemical (ATPase) methods.Results After compression for 1 day, regardless of pressure, and compression for 3 days in the 40 mmHg pressure group, edematous changes in regions with mild inflammation and increases in fiber diameter were observed in the muscles. After compression for 3 days in the 80 and 120 mmHg pressure groups, and after 1, 2, or 4 weeks in the 40 mmHg pressure group, a few necrotic fibers and scattered fibers with some mononuclear cell infiltrates indicative of early stage necrosis were detected. In the groups with 80 or 120 mmHg pressure for 1, 2, or 4 weeks, muscle fibers exhibited marked degenerative changes, which were more pronounced in the 120 mmHg group than in the 80 mmHg group. The pathological changes were more pronounced in the soleus than in the EDL muscles. Conclusion Our findings indicate that repeated compression may cause serious muscle degeneration, particularly in red muscles.