發(fā)布時(shí)間：2018-06-29 19:53

  本文選題：注射性坐骨神經(jīng)損傷 + 膠原纖維��； 參考：《遵義醫(yī)學(xué)院》2011年碩士論文

【摘要】：目的：建立家兔坐骨神經(jīng)干注射性損傷模型；揭示注射性坐骨神經(jīng)損傷對(duì)小腿骨骼肌酶組織化學(xué)的影響；探索其變化規(guī)律；初步探討骨骼肌萎縮的機(jī)制。 方法：選用45只成年健康家兔,體重2.50±0.50kg,分正常組、青霉素注射組、生理鹽水注射共3組。手術(shù)暴露坐骨神經(jīng)干,神經(jīng)外膜下注射青霉素或生理鹽水0.5ml,制造注射性坐骨神經(jīng)損傷模型,采用VG染色法觀察青霉素和生理鹽水注射性坐骨神經(jīng)損傷前、后家兔脛骨前肌和腓腸肌外側(cè)頭內(nèi)膠原纖維變化情況；NADH-TR酶組織化學(xué)染色法研究家兔小腿肌肉的組織化學(xué)特征,比較三種肌纖維的分布與構(gòu)成特點(diǎn),再利用圖像分析系統(tǒng)檢測(cè)小腿肌內(nèi)各型肌纖維橫切面積、光密度和肌纖維型構(gòu)成比的變化；稱量肌重。 結(jié)果：(1)青霉素和生理鹽水注射于坐骨神經(jīng)干外膜下后,出現(xiàn)注射側(cè)后肢拖曳,跛行,小腿外觀變細(xì),健側(cè)運(yùn)動(dòng)自如。肌塊萎縮變薄,色澤由紅潤(rùn)變?yōu)樯n白。(2)脛骨前肌和腓腸肌外側(cè)頭肌重下降。(3)VG染色見正常骨髂肌膠原纖維著為紅色,肌纖維、胞質(zhì)呈黃色,細(xì)胞核呈黑色；青霉素注射于坐骨神經(jīng)干外膜下后2w,脛骨前肌和腓腸肌外側(cè)頭內(nèi)膠原纖維已明顯增生,4w達(dá)高峰,8w時(shí)膠原纖維有所減少,12w時(shí)明顯減少,仍然多于正常；出乎意料的發(fā)現(xiàn)生理鹽水注射同樣導(dǎo)致兩塊肌內(nèi)膠原纖維增生,增生數(shù)量少于青霉素注射引起的增生。(4)NADH-TR酶組織化學(xué)染色可見脛骨前肌和腓腸肌外側(cè)頭內(nèi)能準(zhǔn)確分出三型肌纖維,即Ⅰ型、ⅡA型、ⅡB型；青霉素和生理鹽水注射坐骨神經(jīng),均能引起三型肌纖維構(gòu)成比、光密度、肌纖維橫切面積發(fā)生明顯變化,其中,ⅡB型最不穩(wěn)定,波動(dòng)范圍大,ⅡA型次之,Ⅰ型纖維變化相對(duì)較��；各觀察指標(biāo)的變化在不同時(shí)間點(diǎn)有較大差異,但遵循這個(gè)變化規(guī)律：構(gòu)成比與光密度值是4w8w2w12w正常值,肌纖維橫切面積和肌重正好與前二者相反。青霉素注射引起的變化明顯大于生理鹽水注射；青霉素組導(dǎo)致腓腸肌外側(cè)頭的損傷程度重于脛骨前肌,生理鹽水組未引起兩肌差異性的損傷。 結(jié)論：(1)青霉素與生理鹽水注射于坐骨神經(jīng)干外膜下,均可引起小腿骨骼肌膠原纖維增生,煙酰胺腺嘌呤二核苷酸四唑氧化還原酶激活；(2)注射性坐骨神經(jīng)損傷后,膠原纖維增生及煙酰胺腺嘌呤二核苷酸四唑氧化還原酶活性的改變具有時(shí)間依從性；(3)骨骼肌膠原纖維增生及煙酰胺腺嘌呤二核苷酸四唑氧化還原酶活性增強(qiáng)可導(dǎo)致注射性坐骨神經(jīng)損傷后小腿肌的萎縮。
[Abstract]:Objective: to establish an injection-induced injury model of sciatic nerve trunk in rabbits, to reveal the effect of injection-induced sciatic nerve injury on the histochemistry of skeletal muscle enzymes in the leg, to explore its change rule and to explore the mechanism of skeletal muscle atrophy. Methods: 45 healthy adult rabbits, weighing 2.50 鹵0.50 kg, were divided into 3 groups: normal group, penicillin injection group and saline injection group. The sciatic nerve was exposed to the sciatic nerve trunk and penicillin or normal saline was injected under the epineurium. The model of sciatic nerve injury induced by injection of penicillin and saline was made. The injury of sciatic nerve was observed before penicillin and saline injection by VG staining. The changes of collagen fibers in the anterior tibial muscle and the lateral head of gastrocnemius were studied by NADH-TR enzyme histochemical staining, and the distribution and composition of the three muscle fibers were compared. Then the changes of cross-sectional area, optical density and muscle fiber composition ratio of various types of muscle fibers in the calf muscle were detected by image analysis system, and the weight of muscle was measured. Results: (1) after injection of penicillin and normal saline under the epiglotum of the sciatic nerve, the hind limbs of the injection side were dragged, limped, the appearance of the leg became thin, and the healthy side moved freely. (2) the weight of anterior tibial muscle and lateral head muscle of gastrocnemius decreased. (3) VG staining showed that the collagen fibers of normal bone and iliac muscle were red, muscle fiber was yellow and nucleus was black. 2 weeks after penicillin injection, collagen fibers in the anterior tibial muscle and the lateral head of gastrocnemius were obviously proliferated at the end of 4 weeks and reached the peak at 8 weeks after injection of penicillin into the sciatic nerve trunk. At 12 weeks after injection, the collagen fibers decreased significantly and were still more than normal. Unexpectedly, physiological saline injection also resulted in the proliferation of two intramuscular collagen fibers, which was less than that caused by penicillin injection. (4) NADH-TR histochemical staining showed that the three types of muscle fibers could be accurately distinguished from the lateral head of the tibia muscle and the lateral gastrocnemius muscle by NADH-TR histochemical staining. Type I, type 鈪，

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