磁共振DTI定量评价脉络宁注射液对非压迫性腰神经根炎疗效的实验研究

An experimental study of magnetic resonance DTI quantitative evaluation on effect of Mailuoning Injection for non-compressive lumbar radiculitis

目的探索运用磁共振扩散张量成像(MR-DTI)定量评价脉络宁注射液对非压迫性腰神经根炎的疗效。方法选取巴马小型猪9只,分入A组、B组、C组,各3只,在CT引导下建立非压迫性腰神经根炎模型,各组于造模后14d硬膜外分别注射脉络宁(10mL)、生理盐水(10mL)、消炎液(10mL),造模前、造模后14d、治疗前均进行MR-DTI扫描,治疗后3、7、14d分别从各组取出1只实验猪进行MR-DTI扫描后处死并取神经根标本进行免疫组织化学检测,在MR-DTI图像中测量神经根各向异性分数(FA)值,对FA值和免疫组织化学结果进行统计学分析。结果 MR-DTI:各组造模后FA值均降低(P<0.05);A组治疗后14dFA值回升,与治疗前比较,差异有统计学意义(P<0.05);A组治疗后3、7dFA值无明显上升,A、B两组间比较,差异无统计学意义(P>0.05),但C组FA值回升较其他两组早且迅速(P<0.05);治疗后14d,A组FA值回升,双侧神经根FA值分别与B组、C组比较,差异均无统计学意义(P>0.05),而B组和C组间FA值比较差异有统计学意义(P<0.05)。免疫组织化学:治疗后7d,A组神经组织肿瘤坏死因子α(TNF-α)的积分吸光度值(IA值)开始下降;治疗后14d,A组与C组TNF-αIA值较B组明显降低,差异有统计学意义(P<0.05)。结论脉络宁注射液对非压迫性腰神经根炎具有一定疗效,并可用DTI对其进行评价。

Objective To investigate use of magnetic resonance diffusion tensor imaging （MR-DTI） for quantitatively evalua- ting the efficacy of Mailuoning Injection on non-compressive lumbar radiculitis. Methods Nine Bama mini pigs were seIected and di- vided into group A,B and C,3 cases in each group. The non-compressive lumbar radiculitis model was established under CT-guid- ing. The corresponding therapeutic drugs （group A：10 mL Maildoning;group B：10 mL normal saline ; group C：10 mL diminishing inflammation fluid） were given by epidural injection on 14 d after constructing model. MR-DTI was performed before model con- struction, 14 d after model construction and before treatment. One experimental pig in each group was taken on 3,7,14 d after treat- ment,performed MR-DTI and killed for taking the nerve root sample to conduct the immunohistochemical detection. The fractional anisotropy （FA） values of nerve root in MR-DTI imaging were measured. The FA values and immunohistochemical detection re- sults were statistically analyzed. Results MR-DTI： the FA values after model construction in each group was decreased （P〈 0.05） ;the FA values on 14 d after treatment in the group A was increased, which showed statistically significant difference com- pared with before treatment （P〈0.05）;the FA values after 3,7 d treatment in the group A had no obvious increase, the difference between the group A and B was not statistically significant （P〈0. 05） ,but the FA values increase in the group C was earlier and more rapid than other two groups （P〈0.05） ;the FA values after 14 d treatment in the group A was risen again,the FA values of bilateral nerve roots had no statistical difference between the group A with the group B and C （P〉0.05） ,while the FA values had statistical difference between the group B and C （P〈0.05）. The immunohistochemical results ;TNF-a integral absorbency value（IA value） on 7 d after treatment in the group A began to decline;the TNF-α IA value on 14 d after treatment in the group A and C was significantly decreased compared to group B,the difference was statistically significant （P〈0.05）. Conclusion Mailuoning Injec- tion has a certain effect on non-compressive lumbar radiculitis,which can be evaluated by using DTI.