外源性睫状神经营养因子对喉神经再生的趋向作用

The neuroattract growth effect of ciliary neurotrophic factor on recurrent laryngeal nerve regeneration

目的 探讨睫状神经营养因子 (ciliaryneurotrophicfactor,CNTF)对喉返神经再生的趋向作用。方法 实验犬分成 4组 (每组n =7) ,硅管桥接喉返神经CNTF治疗 (A组 )及生理盐水治疗 (B组 ) ,喉返神经端端吻合CNTF治疗 (C组 )及生理盐水治疗 (D组 ) ,治疗共 1个月。术后 2、3、4个月作喉镜、神经电生理学检查 ,末次检查后作辣根过氧化物酶 (horseradishperoxidase,HRP)逆行追踪、神经组织学及超微结构观察。结果 A、C组全部 ,B组 3只犬恢复生理性声带运动功能 ,而D组均无功能恢复。A、C组喉内肌未记录到错向再生电位 ,而B、D组则分别有 3、6只犬错向再生电位明显 ,B组平均错向再生电位幅度明显小于D组 (t=2 5 0 ,P =0 0 3)。A组疑核运动神经元HRP标记胞体数明显多于B组 (t=3 2 4,P =0 0 1) ,而结状神经节内标记胞体数两组间差异无显著性。A、C组再生神经纤维数量、直径、髓鞘厚度均明显多于或大于B、D组 (P <0 0 5 )。而A与C ,B与D组间差异均无显著性意义。结论 CNTF对周围神经有选择性促进运动神经纤维再生的作用 。

Objective To investigate the neuroattract growth effect of Ciliary neurotrophic factor (CNTF) on recurrent laryngeal nerve (RLN) regeneration. Methods 28 canines were divided into 4 groups (n=7).RLN was severed and sutured in silicone chamber.CNTF or saline were injected into silicone chambers during nerve repair and injected subcutaneously every day after surgery in group A and B respectively.In group C and D, end to end anastomosis of RLN was performed,and CNTF or saline was used respectively for one month. The nerve regeneration and neuroattract growth effect were evaluated with electrophysiological,morphological examination and horseradish peroxidase(HRP) retrograde tracing 2,3 and 4 months postoperatively. Results Physiological adductory and adductory motion was observed in all 7 cases in group A and C respectively,and in 3 cases in group B.No motion in group D.Misdirected electrical activity by misdirected nerve regeneration was found in 3 cases in group B and 6 cases in group D.On average,the potential of misdirected electrical activity in group D was significantly greater than that in group B (P<0.05).Compared with group B,the number of HRP retro-gradely labeled motoneuron increased significantly in group A in ambiguous nucleus ,but in nodosity shape ganglia the number of the labeled neurons were not significantly different between group A and B.The average number and diameter of myelinated axons in the group A and C were significantly greater than those in group B and D,but no significant difference was found between group A and B,D and C respectively. Conclusion The results suggested that exogenous CNTF can enhance motor axon regeneration and have neuroattract growth effect on recurrent laryngeal nerve regeneration.