【摘要】：目的:應用皮膚神經(jīng)活檢技術初步探索大鼠周圍神經(jīng)損傷時皮膚神經(jīng)病理的改變,比較表皮神經(jīng)纖維密度與坐骨神經(jīng)功能指數(shù)、神經(jīng)傳導速度測定結(jié)果的相關性,為周圍神經(jīng)損傷的評估提供參考依據(jù)。方法:采用Wistar大鼠50只,單側(cè)進行大鼠坐骨神經(jīng)損傷模型制作,對側(cè)作為正常對照,在術后2周、4周、6周、8周4個時間點,通過皮膚神經(jīng)活檢、免疫組織化學技術,采用C5型目鏡測微尺及Image-pro plus6.0圖像分析軟件對損傷后的皮膚神經(jīng)纖維進行定量,同時進行各個時段的坐骨神經(jīng)功能指數(shù)測定和神經(jīng)傳導速度檢測,對神經(jīng)損傷后不同階段及恢復程度進行各個指標的相關性分析。結(jié)果:1、皮膚中的表皮神經(jīng)纖維對PGP9.5有高度免疫反應性,鏡下可見大鼠表皮有豐富的神經(jīng)纖維支配。2、大鼠足背部IENFD正常參考值為20.94±0.34fibers/mm2。3、在坐骨神經(jīng)損傷后,IENFD呈明顯下降,隨著術后恢復時間的逐漸延長,IENFD呈逐漸升高的趨勢,且與坐骨神經(jīng)功能指數(shù)及神經(jīng)傳導速度均呈正相關(大鼠坐骨神經(jīng)損傷側(cè)足背部IENFD與坐骨神經(jīng)功能指數(shù)評分比較:2周r=0.977,P0.001;4周r=0.956,P0.001;6周r=0.936,P0.001;8周r=0.996,P0.001;大鼠坐骨神經(jīng)損傷側(cè)足背部IENFD與神經(jīng)傳導速度比較:2周r=0.860,P0.001;4周r=0.912,P0.001;6周r=0.728,P0.001;8周r=0.542,P0.001)。4、IENFD在損傷恢復過程中數(shù)值變化曲線更陡峭,恢復速度更快。結(jié)論:皮膚神經(jīng)活檢可用于周圍神經(jīng)損傷的評估,IENFD在坐骨神經(jīng)損傷后恢復過程中的動態(tài)變化與坐骨神經(jīng)指數(shù)、神經(jīng)傳導速度有很強相關性,且與病變的嚴重程度相一致,相對于其他兩項指標,IENFD對于周圍神經(jīng)損傷的評估可能更敏感。
[Abstract]:Objective: to explore the changes of skin neuropathies during peripheral nerve injury in rats by skin nerve biopsy technique, and to compare the correlation between the density of epidermal nerve fibers and sciatic nerve function index and nerve conduction velocity. To provide a reference for the evaluation of peripheral nerve injury. Methods: 50 Wistar rats were used to make sciatic nerve injury model on one side, and the contralateral sciatic nerve injury model was used as normal control. Skin nerve biopsy and immunohistochemistry were performed at 4 time points, 2 weeks, 4 weeks, 6 weeks and 8 weeks after operation. C5 eyepiece micrometer and Image-pro plus6.0 image analysis software were used to quantify the injured skin nerve fibers, and the sciatic nerve function index and nerve conduction velocity were measured. Correlation analysis of different stages and degree of recovery after nerve injury was carried out. Results: 1. The epidermal nerve fibers in the skin were highly immunoreactive to PGP9.5, and there were abundant nerve fibers innervated in the epidermis of the rat under microscope. 2. The normal reference value of IENFD in the back of the foot was 20.94 鹵0.34 fibers / mm2.3, respectively. After sciatic nerve injury, IENFD decreased significantly, and IENFD increased gradually with the prolongation of postoperative recovery time. There was a positive correlation with the sciatic nerve function index and nerve conduction velocity (compared with the sciatic nerve function index score of the sciatic nerve injury side foot back IENFD: 2 weeks rr 0.977U P 0.001; At 4 weeks rn 0.956 P0.001 / 6 weeks r0.936 P0.001 / 8 weeks rr 0.996 / P0.001.Compared with the nerve conduction velocities of the lateral dorsal pedis of rats with sciatic nerve injury: 2 weeks rr 0.860 P 0.001 / 4 weeks r0.912 P 0.001; (4) the curve of numerical change of IENFD was steeper and the speed of recovery was faster during the recovery of injury. Conclusion: skin nerve biopsy can be used to evaluate the peripheral nerve injury. The dynamic changes of IENFD in the recovery process of sciatic nerve injury have strong correlation with sciatic nerve index and nerve conduction velocity, and are consistent with the severity of the lesion. IENFD may be more sensitive to the assessment of peripheral nerve injury than the other two.
【學位授予單位】：河北大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R745

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