曲安奈德与甲基泼尼松龙影响周围神经再生的比较

背景：有研究证实甲基泼尼松龙在周围神经损伤后应用可促进神经再生;而曲安奈德在周围神经损伤方面的治疗效果尚未见报道。 目的：对比观察曲安奈德与甲基泼尼松龙在兔周围神经损伤后神经再生中的作用。 方法：36只新西兰大白兔随机数字表法分为曲安奈德组,甲基泼尼松龙组和对照组。兔双侧胫神经切断后行端端缝合,吻合口周围各组分别用曲安奈德注射液、甲基泼尼松龙注射液、生理盐水局部注射。 结果与结论：曲安奈德组和甲基泼尼松龙组步态、足底溃疡及愈合情况均优于对照组,且均较少出现神经吻合口周围粘连,镜下观察吻合口周围再生神经纤维较多,结缔组织增生较少;在神经传导速度、有髓神经纤维再生率、小腿三头肌湿质量比等方面明显优于对照组(P < 0.01)。曲安奈德组和甲基泼尼松龙组在上述各指标中无明显差异(P > 0.05)。提示周围神经损伤修复中局部应用曲安奈德或甲级泼尼松龙处理神经吻合口,能有效防止周围神经粘连,促进周围神经再生。

Effect of triamcinolone acetonide and methylprednisolone on peripheral nerve regeneration

BACKGROUND:Research has shown that the application of methylprednisolone can promote peripheral nerve regeneration after injury. However, the research on the effect of triamcinolone acetonide in the treatment of peripheral nerve injury has not been reported. OBJECTIVE:To investigate and compare the effect of triamcinolone acetonide and methylprednisolone on peripheral nerve regeneration after peripheral nerve injury in New Zealand rabbits. METHODS:Thirtysix New Zealand white rabbits were randomly divided into three groups: triamcinolone acetonide group, methylprednisolone group and normal saline control group. The tibial nerves on both sides of New Zealand rabbits were cut and sutured by end-to-end method. The sutured areas were treated with local injection of triamcinolone acetonide, methylprednisolone and normal saline in each group. RESULTS AND CONCLUSION:The gait ability and plantar ulcer healing status in the triamcinolone acetonide group and methylprednisolone group were significantly better than those in the control group, less appearance of nerve anastomsis; in histological examination, more regenerative nerve fiber and less connective tissue hyperplasia were observed around the anastomosed site. The nerve conduction velocity, the regeneration ratio of myelinated nerve fiber and the wet mass of triceps surae muscle in the triamcinolone acetonide group and methylprednisolone group were obviously better than those in the control group (P < 0.01). But there was no significant difference between triamcinolone acetonide group and methylprednisolone group in above parameters (P > 0.05). Local application of triamcinolone acetonide or methylprednisolone to the anastomosed site in the repair surgery of peripheral nerve injuries can effectively prevent adhesion and promote regeneration of peripheral nerve.