本文關鍵詞： 脛神經(jīng)瘤移置模型 神經(jīng)瘤壓痛 神經(jīng)營養(yǎng)素 神經(jīng)生長因子 腦源性神經(jīng)營養(yǎng)因子　出處：《上海交通大學學報(醫(yī)學版)》2017年01期 　論文類型：期刊論文

【摘要】：目的·建立大鼠脛神經(jīng)瘤移置(TNT)模型,觀察損傷神經(jīng)水平及背根神經(jīng)節(jié)(DRG)和脊髓內(nèi)神經(jīng)營養(yǎng)素(NTs)家族中神經(jīng)生長因子(NGF)和腦源性神經(jīng)營養(yǎng)因子(BDNF)的表達變化,初步探討外周神經(jīng)損傷后NTs表達變化對神經(jīng)瘤形成和疼痛相關行為學的影響。方法·將大鼠脛神經(jīng)橫斷并經(jīng)皮下隧道移置在外踝上方皮下,建立TNT模型。于術后不同時間點應用Von Frey纖維絲測量神經(jīng)瘤壓痛和足底機械刺激反應閾值(PWT);實驗終點處死大鼠,取損傷脛神經(jīng)斷端,Neurofi lament-200熒光標記神經(jīng)纖維觀察脛神經(jīng)斷端神經(jīng)瘤形成情況。再次造模,并分別于第7、21、42、49日處死大鼠,取損傷側(cè)脛神經(jīng)、DRG和脊髓,ELISA檢測脛神經(jīng)和DRG中NGF和BDNF的表達變化,Western blotting檢測脊髓中NGF和BDNF的表達變化。結果·術后第7日,神經(jīng)瘤壓痛反應頻率和評分顯著升高;術后第3日,足底外側(cè)緣PWT開始降低且神經(jīng)瘤壓痛和足底外側(cè)機械痛持續(xù)整個實驗周期;但足底中部PWT無明顯變化。脛神經(jīng)免疫熒光染色表明損傷神經(jīng)斷端神經(jīng)瘤形成。ELISA檢測結果顯示:脛神經(jīng)內(nèi)NGF表達增加,BDNF在術后第7、21日表達升高后逐漸降至正常水平;DRG內(nèi)NGF在術后第7、21日表達升高后逐漸降至正常水平,BDNF在術后第7日表達升高后逐漸降至正常水平。在脊髓水平,在術后不同時間點NGF和BDNF的表達均升高并持續(xù)整個實驗周期。結論·TNT可導致大鼠損傷神經(jīng)斷端神經(jīng)瘤形成及神經(jīng)病理性疼痛(神經(jīng)瘤壓痛和足底機械痛覺高敏),其發(fā)生和發(fā)展過程可能與NGF和BDNF有關。
[Abstract]:Objective: to establish TNT model of rat tibial neuroma. The level of injured nerve and the expression of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in DRG (dorsal root ganglion) and neurotrophin (NTs) family in spinal cord were observed. Objective: to investigate the effect of NTs expression on neuroma formation and pain related behavior after peripheral nerve injury. Methods: the tibial nerve was transected and subcutaneous tunnel was placed above the lateral malleolus. The TNT model was established. Von Frey fibril was used to measure the tenderness of neuroma and the threshold of plantar mechanical stimulation at different time points after operation. The rats were killed at the end of the experiment. Neurofi lament-200 labeled nerve fibers were taken from the injured tibial nerve to observe the formation of neuroma at the broken end of the tibial nerve. The rats were killed on the 7th day at the 21st day and the rats were killed on the 9th day. The expression of NGF and BDNF in the tibial nerve and DRG were detected by Elisa and the tibial nerve was taken from the injured side of the tibial nerve. Western blotting was used to detect the expression of NGF and BDNF in spinal cord. Results: on the 7th after operation, the frequency and score of tenderness response were significantly increased. On 3rd, PWT began to decrease in the lateral margin of the plantar and the tenderness of neuroma and mechanical pain on the lateral plantar continued throughout the experimental cycle. But there was no obvious change of PWT in the middle of plantar. The expression of NGF in the tibial nerve was increased by immunofluorescence staining of tibial nerve. The expression of BDNF decreased gradually to normal level at the 7th and 21st postoperatively. The expression of NGF in DRG gradually decreased to normal level on the 7th postoperative and 21st, and then decreased to normal level on 7th after operation, and then decreased to normal level at spinal cord level. The expression of NGF and BDNF increased at different time points after operation and lasted for the whole experiment cycle. Conclusion: TNT can induce neuroma formation and neuropathic pain in injured rats. Neuroma tenderness and plantar mechanical pain Gao Min. Its occurrence and development may be related to NGF and BDNF.
【作者單位】： 上海交通大學附屬第六人民醫(yī)院疼痛科;
【基金】：國家自然科學基金(81370933,81400803,81672237)~~
【分類號】：R739.4;R-332
【正文快照】： 疼痛是截肢后的常見并發(fā)癥,臨床表現(xiàn)為幻肢痛和殘肢痛。在經(jīng)受截肢手術的打擊之后,約80%的截肢患者出現(xiàn)幻肢痛;另外,約有61%的患者遭受殘肢痛的困擾[1-2]。目前認為,截肢后疼痛的發(fā)病機制可能與斷端神經(jīng)瘤形成有關[3-5]。 損傷的外周神經(jīng)有強大的再生能力。在其再生過程中,神

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