球囊导管构建大鼠督脉瘀阻型上颈脊髓损伤模型的研究

A governor-vessel-blockade-type upper cervical spinal cord injury rat model created using Foley's tube

目的:探讨构建大鼠督脉瘀阻型上颈脊髓损伤模型的有效方法。方法:选取30只3月龄SPF级Wistar大鼠,随机分为正常组、假手术组和模型组,每组10只。正常组不进行处理,其余2组大鼠经寰枕间隙置入球囊导管。麻醉苏醒后24 h,正常组和假手术组大鼠直接进行实验观察;在模型组大鼠的球囊导管末端连接手推压力泵,推注碘海醇注射液加压至3 bar(1 bar=100 kPa),持续加压1 h后进行实验观察。观察各组大鼠活动情况及体征,采集四诊信息,按照自拟的督脉瘀阻证辨证标准进行中医辨证。对各组大鼠行颈椎MRI检查,选择横断位T2WI上脊髓受压最严重的层面,测定脊髓最小径和最大径,计算脊髓压迫率(最小径∕最大径)。同时采用改良Tarlov评分法和BBB评分法对假手术组和模型组大鼠的运动功能进行评定。结果:造模后正常组和假手术组大鼠精神状态良好,喜动,活动灵活,皮毛光泽,唇色淡红,耳色淡,爪色淡红;模型组大鼠精神萎靡,蜷缩,活动减少,步态不稳,垂尾,唇色暗红,耳暗红,爪色青紫。按照自拟的辨证标准,模型组属督脉瘀阻证。模型组脊髓压迫率低于假手术组(0.64±0.04,0.73±0.04,t=4.672,P=0.000)。3组大鼠Tarlov评分、BBB评分总体比较,组间差异均有统计学意义[(4.98±0.18)分,(4.82±0.43)分,(4.17±0.60)分,F=9.408,P=0.001;(20.91±0.23)分,(21.01±0.36)分,(16.10±0.71)分,F=111.516,P=0.000];正常组和假手术组Tarlov评分、BBB评分比较,组间差异均无统计学意义(P=0.420;P=0.631);模型组Tarlov评分、BBB评分均低于正常组和假手术组(P=0.000,P=0.000;P=0.003,P=0.000)。结论:经寰枕间隙置入球囊导管并注射造影剂加压,可构建大鼠督脉瘀阻型上颈脊髓损伤模型。

Objective： To explore the effective method for building a governor - vessel - blockade - type upper cervical spinal cord in- jury rat model. Methods ： Thirty 3 - month - old SPF - grade Wistar rats were selected and randomly divided into normal group, sham - op- erated group and model group, 10 cases in each group. The rats in normal group did not receive any treatment, while the rats in the other two groups were treated by inserting a Foley＇s tube into atlanto -occipital space. At 24 hours after anesthesia recovery ,the rats in normal group and sham - operated group were observed immediately ; while in model group the manumotive force - pumps were connected with the tail end of Foley＇s tube and the iohexol injections were injected into the Foley＇s tube continuously till the pressure reached 3 bar（ 1 bar = 100 kPa）. One hour later,the experimental observation was performed on the rats of model group. The activities and signs of all the rats were observed and their diagnostic informations were collected and the traditional Chinese medicine （TCM）syndrome differentiation were carried out ac- cording to self - made syndrome differentiation standard. The cervical MRI examination were performed on rats in each group and the trans- verse T2 -weighted MRI on which the most serious compression of spinal cord were found were selected for measuring the minimal and maximal diameters of spinal cord, and then the spinal cord compression ratios （ ratio of minimal diameter to maximal diameter of spinal cord） were calculated. The motor function were evaluated by using improved Tarlov scoring method and BBB scoring method in rats of sham - op- erated group and model group. Results： After modeling, the rats in normal group and sham - operated group were in good mental states and liked activities and presented with flexible movement, shiny fur, reddish lips, light -colored ears and reddish paws. ＂The rats in model group were in bad mental states and dislike activities and presented with instability of gait, drooping tail, dull - red lips and ears and livid paws.According to the self- made syndrome differentiation standard, the TCM symptom complex of rats in model group categorized as governor- vessel - blockade syndrome. The spinal cord c, ompression ratio was lower in model group compared to sham - operated group（0.64 ＋/-0.04 vs 0.73 ＋/-0.04,t = 4. 672,P = 0. 000）. There was statistical difference in Tarlov scores and BBB scores between the 3 groups（4.98 ＋/- 0.18,4.82 ＋/- 0.43,4. 17 ＋/- 0.60 points, F = 9. 408,P = 0. 001 ;20.91 ＋/- 0.23,21.01 ＋/- 0. 36, 16. 10 ＋/- 0.71 points, F = 111.516,P = 0. 000）. There was no statistical difference in Tarlov scores and BBB scores between normal group and sham - operated group （P =0. 420;P = 0. 631 ）. The Tarlov scores and BBB scores were lower in model group compared to normal group and sham- operated group （ P = 0. 000, P = 0. 000 ; P = 0. 003, P =0. 000 ）. Conclusion ： The governor - vessel - blockade - type upper cervical spinal cord inju- ry rat models can be build by inserting Foley＇s tube and injecting contrast medium under pressuse into the atlanto - occipital space of rats.