周围神经移植联合神经营养因子治疗损伤脊髓的实验研究

目的 探讨周围神经移植联合神经生长因子(NGF)和脑源性神经生长因子(BDNF)对脊髓损伤的疗效。方法 用SD大鼠在胸8～胸9平面切除半侧4mm长脊髓制成半切模型,取自体肋间神经桥接脊髓缺损,并在局部持续灌注含NGF、BDNF生理盐水3天。3个月后由结构及功能二方面评价脊髓功能恢复情况。结果 术后3个月试验鼠后肢感觉、运动及运动功能改良Tarlov评分、斜板试验均优于对照组;肋间神经植入区见轴突再生,胶质细胞增生减少,雪旺氏细胞增殖;示踪剂通过植入区的近远端界面;体感诱发电位(SEP)磁刺激运动诱发电位(MEP)大部分恢复;MR示脊髓连续无中断。结论 肋间神经移植 NGF、BDNF能促进神经轴突的生长,抑制胶质细胞增生,在局部使雪旺氏细胞增殖,利于脊髓再生。

The experimental study of the treatment on injured spinal cord by peripheral nerve transplantation in combination with neurotrophic factors

Objective To study the therapeutic effect on injured spinal cord by peripheral nerve transplantation combining nerve growth factor (NGF) and brain-derived neural nutrition factor (BDNF). Methods Hemisection models of spinal cord were fulfilled by cutting 4mm long spinal tissue from T8 to T9 of SD rats, and then the lesion of the spinal tissue was repaired using 6 to 8 intercostal nerves,NGF and BDNF were applied in the early stage after operation. The recovery of spinal cord function were evaluated functionally and structurally three months later. Results Three months after the operation,the improved Tarlov's scores and the results of slanting board test which indicates the recovery of nerve function, including sensory and motor, were better than that of the control groups; regenerated axons and schwann's cells were seen (under the microscopic field) in the lesion,but the proliferation of glial cells were decreased; the tracer can transit the proximal and distal operationg section; the spinal sensory and motorial potential can reach the end of injured spinal cord;MRI showed the continuous spinal cord. Conclusion The procedure of intercostal nerve transplantation combining NGF and BDNF can promote the regeneration of axon and schwann cell, restrain the proliferation of glial cell,and it's a good method for the generation of injured spinal cord.