动脉闭塞犬中枢神经系统感觉神经纤维中前列腺素E1的变化及肢体负压的干预效应

背景:肢体负压治疗周围动脉闭塞性病变,具有方便、安全、无创伤和改善疼痛症状的作用。前列腺素E1可直接松弛血管平滑肌,对神经痛有良好的止痛效果。目的:观察肢体负压对周围动脉闭塞性病变模型犬中枢神经系统感觉神经纤维中前列腺素E1免疫反应阳性神经纤维的影响。设计:随机对照的动物实验。单位:南方医科大学附属珠江医院肿瘤中心,解放军第四军医大学西京医院普外三科。材料:实验于2003-04/2004-05在解放军第四军医大学西京医院动物实验室完成。健康成年杂种犬17只,随机数字表法随机分为3组,治疗组10只、非治疗组5只和正常对照组2只。方法:治疗组和非治疗组均将动物制作左后肢缺血模型,治疗组在模型制作后14d开始行患肢负压治疗,压力为-12kPa,持续15min,1次/d,连续10d;非治疗组不做负压治疗。正常对照组不干预。主要观察指标:各组均于实验开始后24d将动物麻醉后处死,切取L1～L5的脊髓及背根神经节,3组均行脊髓及背根神经节免疫组化染色,检测前列腺素E1免疫反应阳性纤维平均灰度值。结果:犬17只全部进入结果分析。非治疗组、治疗组和正常对照组脊髓前列腺素E1免疫反应阳性纤维平均灰度值分别为75.23±4.3,43.22±3.7,22.00±5.8;背根神经节前列腺素E1免疫反应阳性纤维平均灰度值分别为67.12±2.3,40.08±3.8,27.64±2.7,各组比较差异显著(P均<0.01)。结论:周围动脉闭塞性疾病发病后,远端肢体脊髓及背根神经节中的前列腺素E1免疫反应阳性神经纤维数量明显增多,可能是机体的一种自身保护机制。肢体负压疗法可缓解肢体疼痛,并能减少肢体动脉闭塞性病变伤害性刺激的传入。

Changes of prostaglandin E1 in sensory nerve fiber of central nervous system of dogs with arterial occlusion and interventional effect of negative pressure

BACKGROUND: Negative pressure of limbs is a convenient, safe and unwound way to treat peripheral arterial occlusion and to relieve pain.Prostaglandin E1 can directly rellax vascular smooth muscles and relieve pain on nerve.OBJECTIVE: To observe the effect of negative pressure of limbs immunologic reaction positive nerve fiber of prostaglandin E1 in sensory nerve fiber of central nervous system of dogs with peripheral arterial occlusion.DESIGN: Randomized controlled animalstudy.SETTING: Tumor Center of Zhujiang Hospital affiliated to Southern Medical University, the Third General Surgery of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Animal Laboratory of Xijing Hospital affiliated to the Fourth Military Medical University of Chinese PLA from April 2003 to May 2004. A total of 17 healthy adult hybrid dogs were randomly divided into three groups: treatment group (n=10),non-treatment group (n=5) and normal control group (n=2), according to randomly digital table.METHODS: Ischemic models of left hindlimb were established in treatment group and non-treatment group. Fourteen days later, dogs in treatment group were given negative pressure (-12kPa) treatment for 15 minutes. The negative pressure was done once a day for 10 successive days.However, negative pressure was not done in non-treatment group. Animals were not interfered in normal control group.MAIN OUTCOME MEASURES: Twenty-four days later, dogs in each group were anesthetized and sacrificed. L1-L5 spinal cord and ganglia of dorsal root were selected and stained with immunohistochemical method to detect average giay value of immunologic reaction positive nerve fiber of prostaglandin E 1.RESULTS: A total of 17 dogs were involved in the final analysis. Average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord were 75.23±4.3 in non-treatment group, 43.22±3.7 in treatment group and 22.00±5.8 in normal control group; average gray values of immunologic reaction positive nerve fiber of prostaglandin E1 in ganglia of dorsal root were 67.12±2.3, 40.08±3.8, 27.64±2.7, respectively.There was no significant difference among the three groups (P＜0.01).CONCLUSION: After onset of peripheral arterial occlusion, amount of immunologic reaction positive nerve fiber of prostaglandin E1 in spinal cord and ganglia of dorsal root of distal limbs is increased remarkably, and this may be a kink of auto-protective mechanism of organism. Negative pressure can relieve pain of limbs and decrease damaged-stimulated transmission of peripheral arterial occlusion.