脊髓损伤后孕酮保护作用研究

目的:探讨脊髓损伤后孕酮的保护作用。方法:将54只日本大耳白兔随机均分为假手术组、脊髓损伤组与孕酮治疗组各18只,每组又分为治疗后12 h、24 h、36 h、48 h、72 h和14 d 6个时间点。假手术组只行腹部切开术但不阻断腹主动脉,脊髓损伤组和孕酮治疗组制备缺血再灌注模型,造模后孕酮治疗组注射孕酮治疗,脊髓损伤组在相同时间点注射等量生理盐水。比较各时间点不同组兔神经细胞超微结构变化情况和神经功能(BBB)评分。结果:电镜结果显示,脊髓损伤组可见神经细胞核固缩,异染色质浓染凝集成块,细胞浆中有大量空泡形成。孕酮治疗组可见神经细胞和胶质细胞的核轻度固缩,染色质浓染、细胞浆空泡化均较脊髓损伤组减轻。脊髓损伤组术后12 h BBB评分为0.6分,随后缓慢升高,术后14 d时评分为9.3分。孕酮治疗组BBB评分变化与脊髓损伤组相似,但术后36 h开始,各时间点评分均高于相应脊髓损伤组(P0.05)。结论:脊髓损伤后,采用孕酮治疗可减轻神经细胞变性,发挥神经保护作用。

Protective Effect of Progesterone on Spinal Cord Injury

Objective:To investigate the protective effect of progesterone on spinal cord injury in rabbits.Methods:A total of 54 male Japanese big ear rabbits were randomly divided into sham operation group (n=1 8),spinal cord injury group (n=1 8) and progesterone treatment group (n=1 8),each group was divided into 12h,24h,36h,48h,72h and 14 d after treatment,for a total of six time points.The rabbits of the sham operation group underwent the abdominal incision without abdominal aorta blocking.The rabbits of the spinal cord injury group and progesterone treatment group underwent the ischemia-reperfusion operation.After operation,all the rabbits in the progesterone treatment group were treated by progesterone,while the rabbits in the spinal cord injury group were injected saline at the same time.After accepting different treatments,the postoperative differences of the rabbits between the different time points on cell ultrastructure and BBB score were compared.Results:The spinal cord injury group showed neuronal nuclear pyknosis,heterochromatin stain agglutinate,and there were a large number of vacuolization in the cytoplasm.The progesterone treatment group showed that the nerve cells and glial cells nuclear mild pyknosis,chromatin staining and the cytoplasmic vacuolization were less than those in the spinal cord injury group.The BBB score of the spinal cord injury group after12 hour was 0.6 points,then increased slowly,and after 14 days the score was 9.3.The BBB score of the progesterone treatment group was similar to the changes of the spinal cord injury group,but after 36h,each time point were higher than those in the corresponding spinal cord injury group (all P＜0.05).Conclusion:Progesterone therapy could play a role in neural protection by inhibiting the cell changes.