甲基强的松龙对脊髓爆震伤后运动神经元形态学改变的实验研究

目的观察甲基强的松龙(MP)冲击疗法在脊髓爆震伤后早期救治中的疗效.方法将48只家兔随机分为6h生理盐水组(A组)、24h生理盐水组(B组)、48h生理盐水组(C组)、6h MP组(D组)、24h MP组(E组)及48h MP组(F组),每组8只,采用0.9g黑索金(RDX)对每只家兔进行爆震,伤后1h内A、B、C组给予静脉输入生理盐水,速度为5ml/kg/h,D、E、F组根据NASCISⅡ方案给予MP,A、D组于伤后6h取材,B、E组于伤后24h取材,C、F于伤后48h取材,观察脊髓前角运动神经元的形态和数量的变化.结果爆震伤后6h脊髓运动神经元出现可逆性改变,伤后24h脊髓死亡运动神经元达到最多,并且持续到伤后48h,伤后1h内给予MP冲击治疗后,24h、48h组与对照组相比在正常与坏死神经元的数量方面均表现出显著的统计学差异(P＜0.001).结论脊髓爆震伤后早期给予MP冲击治疗,对脊髓运动神经元具有保护作用.

Morphological changes of motoneuron treating with methylprednisolone after explosive injury of spinal cord

Objective:To observe the effect of methylprednisolone(MP) on the morphological changes of motoneuron after explosive injury of spinal cord.Method:Forty-eight rabbits were randomly divided into normal saline after 6 hour group(group A)?normal saline after 24 hour group(group B)?normal saline after 48 hour group(group C)?MP after 6 hour group(group D)?MP after 24 hour group(group E) and MP after 48 hour group(group F),with each group 8 rabbits,all rabbits were made explosive injury in thoracic vertebra by 0.9g RDX,group A?B and C were injected normal saline after injury,group D?E and F were injected MP after injury,at 6h?24h and 48h after injury spinal specimen were harvested,then the change of the normal nerve cells and metamorphic nerve cells was observed under light microscopes.Result:The reversible change of the nerve cells occured after six hours,which represented denaturalization and edema in some degree,with the time going,the number of necrotic nerve cells would increase gradually,and would peaked at 48h after explosion,in rabbits administered with methylprednisolone after explosive injury,the number of the dead motoneuron decreased significantly compared with those in the control group at 24h or 48h after explosion(P<0.001).Conclusion:Early application of MP after explosive injury of spinal cord can has neuroprotective effect to spinal cord.