重复经颅磁刺激治疗腓总神经损伤的疗效

Therapeutic effect of repetitive transcranial magnetic stimulation therapy on common peroneal nerve injury

目的观察重复经颅磁刺激治疗腓总神经损伤的疗效,探讨对神经生长因子(nerve growth factor,NGF)和碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)的表达影响。方法雄性普通级健康的prague-Dawley新西兰兔80只,随机分为治疗组和模型组各40只,治疗组予重复经颅磁刺激,治疗前后对患肢进行肌电图、运动传导速度检查,并应用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶(streptavidin-perosidase,SP)法对80只兔受损腓总神经组织中的NGF和bFGF的表达进行检测和统计学分析。结果治疗后,2组插入电位延长、纤颤电位指标异常只数明显少于治疗前,运动单位电位指标异常只数明显多于治疗前,差异均有统计学意义(P<0.05)。治疗后,治疗组插入电位延长、纤颤电位指标异常只数明显少于模型组,运动单位电位指标异常只数明显多于模型组,差异均有统计学意义(P<0.05)。治疗后,2组运动神经传导速度及波幅均高于治疗前,治疗组运动神经传导速度及波幅均高于模型组,差异均有统计学意义(P<0.05)。治疗组兔受损腓神经组织中NGF和bFGF的灰度值均明显高于模型组,差异均有统计学意义(P<0.05)。结论重复经颅磁刺激治疗对腓总神经损伤患者下肢的运动功能有明显改善。内源性NGF和bFGF能促进受损周围神经功能恢复、对再生神经组织结构有重建作用,在周围神经损伤的修复起重要作用。

Objective To observe the effect of repetitive transcranial magnetic stimulation on the injury of common peroneal nerve,and to explore the effect on the expression of nerve growth factor(NGF)and basic fibroblast growth factor(bFGF).Methods Eighty male normal healthy Prague Dawley New Zealand rabbits were randomly divided into treatment group and model group.The treatment group was given repeated transcranial magnetic stimulation.Electromyography and motor conduction velocity were examined before and after treatment.The expression of NGF and bFGF in the injured common peroneal nerve tissue of 80 rabbits was detected by streptavidin-perosidase(SP)method The results were tested and analyzed statistically.Results After treatment,the number of abnormal indexes of insertion potential and prolonged fibrillation potential in the two groups was significantly less than that before treatment,and the number of abnormal indexes of motor unit potential was significantly more than that before treatment,the difference was statistically significant(P<0.05).After treatment,the number of abnormal indexes of insertion potential and prolonged fibrillation potential in the treatment group was significantly less than that in the model group,and the number of abnormal indexes of motor unit potential in the treatment group was significantly more than that in the model group(P<0.05).After treatment,the motor nerve conduction velocity and amplitude of the two groups were higher than before treatment,and the motor nerve conduction velocity and amplitude of the treatment group were higher than the model group,the difference was statistically significant(P<0.05).The gray values of NGF and bFGF in the injured peroneal nerve tissue of the treatment group were significantly higher than those of the model group(P<0.05).Conclusion Repetitive transcranial magnetic stimulation therapy can effectively improve the lower limb motor function in patients with common peroneal nerve palsy.NGF and bFGF can promote the functional recovery after PNI,reconstruct the tissue structure of regenerated nerve,and play an important role in the repair ment of peripheral nerve injury.