神经内注射强地松龙,VB1,VB12和氟美松后组织病理学改变

本研究目的是在大鼠神经外膜下注射强的松龙、ＶＢ１、ＶＢ１２和氟美松后，观察是否能引起神经的组织病理学改变。分别将下列药物（２．５％强地松龙；０．５％强地松龙；５％ＶＢ１；１％ＶＢ１；０．２５％ＶＢ１２；０．５％强地松龙＋１．６％利多卡因；０．％氟美松＋１．６％利多卡因；生理盐水１ｍｌ），在手术显微镜下，用皮试地头将药液注入到坐骨神经的神经外膜下，３天至１４后分别取神经标本进行形态学检查，结果显示注

ULTRASTRUCTURAL CHANGES OF RAT SCIATIC NERVE FOLLOWING INTRANEURAL INJECTIONS OF PREDNISONLONE, VITAMIN B_1, VITAMIN B_(12) AND DEXAMETHASON

The aim of this study was to investigate the histopathological changes induced by injection of prednisonlone (Pred), vitamin B1 (VB1), vitamin VB12 (VB12) or dexamethasone (Dex) beneath the epineurium of the sciatic nerve of the rat. 1 ml volumes of either normal saline; 2. 5 % Pred; 0. 5 % Pred; 5% VB1; 1% VB1; 0. 25% VB12; 0. 05 % VB12; 0. 5 % Pred 1. 6% lidocaine or 0.1% Dex 1. 6% lidocaine was injected beneath the epineruium of sciatic nerve. Injections were performed under an dissecting microscope to avoid nerve trauma and to confirm that the test solution formed a local bath around the nerve. The animals were maintained normaly untill the nerves were reexposed for morphologic examination 3 days or 2 weeks later. Optic microscopy (HE staining and Teased fiber) and electron microscopy revealed mild to moderate abnormal myelin sheath resulting from injection of Pred, VB1 and VB12. The nerves injected with high concentration (5%) of VB1 presented severe pathologic changes-axonal necrosis. No significant changes were noted in nerves receiving Dex and normal sa1ine. Pred crystals could be seen 4 weeks later in all animals injected with high concentration (2.5%) of Pred. We conclude that intraneural administration of clinically used concentrations of Pred and VB1 solution can induce severe local neurotoxicity three days following injections. Dex and VBl2 are relatively safe as compared to Pred and VB1.