甲基强的松龙与尼莫地平联合治疗脊髓损伤的实验研究

The experimental study of combined methylprednisolone and nimodipine in treatment of early spinal cord injury in rats

目的通过建立脊髓损伤动物模型,探讨甲基强的松龙MP、尼莫地平联合用药与单独用药对脊髓损伤的疗效差别。方法参照动脉瘤夹压迫法制作SD大鼠T10段脊髓损伤模型,并随机分为4组,分别予MP、尼莫地平、两药联合应用治疗(3组统称为治疗组)及不予治疗(对照组)。于伤后1、2、3、4周末行神经功能评分及斜板试验,伤后24h及2、3、4周末行伤段脊髓HE染色及银染,并行图像分析,伤后3周行皮层诱发电位CSEP及脊髓诱发电位(SCEP)检查。伤后4周行L1段脊髓5-HT免疫组化染色。结果伤后3周神经功能评分治疗组较对照组显著增高P<0.01;伤后2周斜板最大角度治疗组较对照组显著增高P<0.01;伤后3、4周残留神经组织百分率治疗组较对照组显著增高P<0.01,联合治疗组又较MP组及尼莫地平组为高P<0.01;各组CSEP均无恢复,SCEP恢复率各治疗组较对照组高均P<0.01;5-HT免疫组化染色治疗组表达明显,而对照组不明显。结论脊髓损伤后早期应用MP及尼莫地平治疗均有效,两者合用未显示出明显的协同作用。

Objective To investigate the efficacy of combined or single drugs of methylprednisolone (MP) and nimodipine in treatment of early spinal cord injury in rats.Methods Eighty rats were completely paralyzed by aneurysm clip method and randomized into four groups,in which intravenously MP,nimodipine,MP combined with nimodipine and no treatment were administrated respectively.Tarlov scale and inclined plane test were performed at the end of 1,2,3 and 4 weeks after injury,and the histopathologic and immunohistochemical examinations,image analysis,CSEP and SCEP examinations were also performed. Results The Tarlov scale and inclined plane test showed significant differences between three treatment groups and control group and no significant differences among three treatment groups.The results of image analysis showed significant differences between treatment groups and control group,and the combined treatment group showed significant difference with single MP and nimodipine group.The CSEP remained no recovery and the rate of SCEP recovery showed significant differences between treatment groups and control group, meanwhile, no significant difference among treatment groups.Immunohistochemical results showed negative 5-HT fibers in ventral horn of control group but that was positive in treatment groups.Conclusion MP and nimodipine were effective in treatment of early spinal cord injury and both showed neuron protective effects, but there was no significant difference between combined therapy and single-drug therapy.