【摘要】：目的：面肌痙攣病因系面神經(jīng)根出腦干段受周圍腦血管壓迫，，但其具體發(fā)病機(jī)制不明。我們前期研究發(fā)現(xiàn)責(zé)任血管壁外膜中交感神經(jīng)末梢釋放的神經(jīng)遞質(zhì)能觸發(fā)異常肌反應(yīng)波(abnormal muscle response,AMR)。本研究將從責(zé)任血管和面神經(jīng)兩方面進(jìn)一步探索面肌痙攣發(fā)病機(jī)制。 方法：采用Moller面肌痙攣動(dòng)物模型，根據(jù)AMR監(jiān)測(cè)結(jié)果將SD大鼠分組，掃描及透射電鏡分別觀察責(zé)任血管-面神經(jīng)接觸面，免疫組化染色法檢測(cè)面神經(jīng)鈉通道（Nav1.1、Nav1.3、Nav1.6、Nav1.7和Nav1.8）表達(dá)情況，統(tǒng)計(jì)分析AMR監(jiān)測(cè)結(jié)果與電鏡表現(xiàn)、鈉通道表達(dá)情況間的關(guān)系。 結(jié)果：建模完成后，11/18只大鼠監(jiān)測(cè)到AMR波，電鏡發(fā)現(xiàn)AMR陽性大鼠均存在神經(jīng)-血管接觸面的同時(shí)破損，而AMR陰性大鼠中僅有3/7只存在神經(jīng)-血管外膜的損傷(P0.05)。免疫組化部分的實(shí)驗(yàn)發(fā)現(xiàn)，13/14只AMR(+)大鼠中Nav1.8異位高表達(dá)，而AMR(-)大鼠中均未發(fā)現(xiàn)Nav1.8明顯變化(P0.05)。 結(jié)論：責(zé)任血管與面神經(jīng)外膜均破損是面肌痙攣發(fā)病的必要條件，面神經(jīng)興奮性增高與面神經(jīng)膜上Nav1.8異位表達(dá)增多有關(guān)。
[Abstract]:Objective: the etiology of hemifacial spasm is the compression of the brain stem of facial nerve root by peripheral cerebral vessels, but its pathogenesis is unclear. Our previous study found that sympathetic neurotransmitters released in the epigastric membrane of the responsible vessel trigger abnormal muscle response wave (abnormal muscle response,AMR). This study will further explore the pathogenesis of hemifacial spasm from responsible blood vessels and facial nerves. Methods: Moller hemifacial spasm animal model was used. According to the results of AMR monitoring, SD rats were divided into two groups. The responsible vascular-facial nerve interface was observed by scanning and transmission electron microscopy, and the facial sodium channel (Nav1.1,Nav1.3,) was detected by immunohistochemical staining. The expression of Nav1.6,Nav1.7 and Nav1.8, and the relationship between AMR monitoring results, electron microscopic findings and sodium channel expression were analyzed statistically. Results: after modeling, AMR waves were detected in 11 / 18 rats, and AMR positive rats were found to be damaged at the same time. Only 3 / 7 of the AMR negative rats had neurovascular adventitia damage (P0.05). The results of immunohistochemistry showed that 13 / 14 AMR () rats had high expression of Nav1.8, while no significant changes of Nav1.8 were found in AMR (-) rats (P0.05). Conclusion: the damage of the epineurium of the responsible vessels and the facial nerve is a necessary condition for the pathogenesis of hemifacial spasm. The increased excitability of the facial nerve is related to the increase of the ectopic expression of Nav1.8 on the facial nerve membrane.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R745.12

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 曹婷婷,王小花;A型肉毒毒素對(duì)面肌痙攣療效的觀察護(hù)理[J];護(hù)士進(jìn)修雜志;2003年09期

2 王靜;;A型肉毒桿菌毒素治療面肌痙攣[J];中國實(shí)用神經(jīng)疾病雜志;2009年14期

3 朱宏偉;李勇杰;李繼平;馬凱;張宇清;;面肌痙攣顯微血管減壓術(shù)中異常肌反應(yīng)監(jiān)測(cè)價(jià)值研究[J];立體定向和功能性神經(jīng)外科雜志;2006年05期

4 李放;張黎;于炎冰;徐曉利;許駿;任鴻翔;劉江;;面肌痙攣顯微血管減壓術(shù)后遲發(fā)性面癱[J];中華神經(jīng)外科疾病研究雜志;2011年02期

5 李世亭;王旭輝;;面肌痙攣的診斷與治療[J];中華神經(jīng)外科疾病研究雜志;2011年06期

6 杜曉東;舒暢;;A型肉毒素治療復(fù)發(fā)性面肌痙攣[J];江蘇醫(yī)藥;2008年08期

7 趙永宏,李暉,米修奎,劉憶華,湯亞偉,蔡其剛;特發(fā)性面肌痙攣——面神經(jīng)根部病因?qū)W觀察[J];中國耳鼻咽喉顱底外科雜志;2005年03期

8 于炎冰;;顯微血管減壓術(shù)與面肌痙攣[J];中國微侵襲神經(jīng)外科雜志;2007年09期

9 李繼平;張宇清;李勇杰;;異常肌反應(yīng)電生理監(jiān)測(cè)在面肌痙攣顯微血管減壓術(shù)中的應(yīng)用[J];中國微侵襲神經(jīng)外科雜志;2011年02期

本文編號(hào)：2341975