复方丹参注射液对兔压迫性颈髓损伤减压术后疗效影响的实验研究

Adjuvant Therapeutic Effect of Compound Radix Salviae Miltiorrhizae on Decompression of Compressive Cervical Spinal Cord Injury in Rabbits

目的探讨复方丹参注射液对压迫性颈髓损伤减压后继发性缺血再灌注损伤干预作用。方法雄性新西兰白兔24只,随机分为压迫组、复方丹参+减压组、减压组和正常对照组,每组6只。除正常对照组外,余三组建立兔颈髓压迫损伤动物模型。复方丹参+减压组在减压术前及术后给予静脉注射复方丹参注射液2g/(kg·d),压迫组与减压组给予等体积生理盐水,正常对照组动物不进行手术操作。观察兔后肢并进行运动功能评分、颈髓组织学检查、细胞凋亡及免疫组化检查。结果减压第1、28天时复方丹参+减压组兔后肢运动功能评分分别为(5.33±0.58)分及(6.00±0.00)分,均显著大于减压组(3.67±0.58)分及(5.00±0.00)分(P<0.05)。组织学检查显示,复方丹参+减压组兔颈髓神经元水肿及神经胶质细胞增生较减压组轻。兔颈髓组织免疫组化检测显示在第28天时,复方丹参+减压组血管数(12.33±2.12),显著多于压迫组的(5.67±2.50)(P<0.05),及减压组(9.78±2.17)(P<0.05)。细胞凋亡检测显示减压术后第1、28天,复方丹参+减压组颈髓组织凋亡指数分别为(0.89±0.33)及(0.56±0.53),显著小于压迫组的(2.22±1.56)及(4.00±2.12)(P<0.05),减压组的(1.78±0.67)及(1.67±0.50)(P<0.05),与正常对照组(0.78±0.44)及(0.56±0.53)比较,差异无统计学意义(P>0.05)。结论复方丹参注射液可改善压迫性颈髓损伤兔减压术后脊髓的微循环,减轻减压术后缺血再灌注损伤,增强减压术的疗效,促进术后运动功能的恢复。

decompression, with all P〈0.05. Tunnel assay showed that apoptosis index of cervical spinal cord in combined treatment group were 0.89 ±0.33 and 0.56 ±0.53, which were significantly lower than those of compression group （2.22±1.56 and 4.00±2.12, P〈0.05） and decompression group （1.78±0.67 and 1.67±0.50, P〈0.05） on day 1 and 28 after decompression, but did not differ from those of healthy group （0.78±0.44 and 0.56±0.53, P〉0.05）. Conclusion Compound radix salviae miltiorrhizae can improve microcirculation of spinal cord after decompression of compressive spinal cord injury, decrease ischemic reperfusion injury after decompression, enhance therapeutic effects of decom-pression, and promote motor function recovery after operation.