神经端侧缝合后趋化性的神经元逆行示踪研究

目的 应用神经元荧光逆行示踪技术探讨外周神经端侧缝合后神经再生的趋化性问题. 方法 选用雌性SD大鼠40只,随机分为4组,端侧缝合肌皮神经主干标记组、正常肌皮神经主干标记组、端侧缝合肌皮神经肌支标记组和正常肌皮神经肌支标记组,每组10只.端侧缝合的两组切断肌皮神经,尺神经后内侧方外膜开窗,将肌皮神经和开窗的尺神经外膜做端侧缝合,正常对照两组仅显露肌皮神经和尺神经.5个月后采用Fhuoro-Gold荧光逆行示踪技术,标记第一、二组肌皮神经主干和第三、四组肌皮神经肌支,精确计数各组大鼠脊髓C4-T1前角和背根神经节神经元. 结果 在肌皮神经主干标记两组中,端侧组脊髓前角神经元数目占正常组的30.0%(P＜0.01);背根神经节感觉神经元数目占正常组的28.1%(P＜0.01),运动神经元比例为0.36±0.09,与正常组差异无统计学意义(P＞0.05).在肌皮神经肌支标记两组中,端侧组脊髓前角神经元数目占正常组的38.1%(P＜0.01),背根神经节感觉神经元数目占正常组的70.2%(P＞0.05),运动神经元比例为o.40±0.14.与正常组差异有统计学意义(P＜0.01). 结论 外周神经端侧缝合后神经侧方出芽对特定靶器官的趋化性不明显.

Neurotropism following end-to-side neurorrhaphy by neuron retrograde tracing technique

Objective To detect whether there is neurotropism following end-to-side neurorrhaphy by means of the neuron retrograde tracing technique. Methods Forty female Sprague-Dawley rats were randomly divided into 4 groups: tracing main branch of musculcutaneous nerve(MC) of end-to-side group, tracing MC main branch of normal group, tracing MC motor branch of end-to-side group and tracing MC motor branch of normal group.In two end-to-side groups, the MC was transeeted, then an 1 mm epineukral window was created on the ulnar nerve. Distal end of MC nerve was sutured to the windowed ulnar nerve by means of end-to-side neurorrhaphy.In two normal control groups, MC and ulnar nerves were just exposed. Five months post operation, by means of retrograde Fluoro-Gold neuron tracing technique,the number of C5～ T1 anterior horn motoneurons and dorsal root ganglion sensory neurons of all groups were counted. Results In two tracing MC main branch groups: the motor neuron counts in end-to-side group was 245.2 ± 93.8, the motor neuron counts in normal group was 846.7 ± 264.8, and counts of end-to-side group was 30.0% of the normal control group (P＜ 0.01). The sensory neuron counts in end-to-side was 434.7 ± 160.4, the sensory neuron counts in normal group was 1545.2 ± 287.4, and counts of end-to-side group was 28.1% of the normal control group (P ＜ 0.01). The per-centage of motor neuron in end-to-side group was 0.36 ± 0.09, there was no difference between end-to-side group and normal control group(P＞ 0.05). In two tracing MC motor branch groups: the motor neuron counts in end-to-side group was 72.3 ± 35.3, the motor neuron counts in normal group was 189.7 ± 57.0, and counts of end-to-side group was 38.1% of the normal control group (P ＜ 0.01). The sensory neuron counts in end-to-side was 110.8 ± 52.5, the sensory neuron counts in normal group was 157.9 ± 50.0, and counts of end-to-side group was 70.2% of the normal control group (P ＞ 0.05). The percentage of motor neuron in end-to-side group was 0.40 ± 0.14, the difference between end-to-side group and normal control group was signifieant(P ＜ 0.01 ). Conclusion Neurotropism in collateral spouting after end-to-side neurorrhaphy is not significant.