林世德;张俊江;臧宇杰;赵廷宝;

• 1:济南军区总医院脊髓修复科

摘要(Abstract)：

[目的]观察脊髓损伤(spinal cord injury,SCI)后发生中枢性疼痛(central pain,CP)大鼠损伤远端脊髓背角中生长相关蛋白43(GAP-43)和降钙基因相关肽(CGRP)的共定位表达情况,探讨CP与CGRP阳性的初级传入神经纤维出芽再生之间的关系。[方法]SD大鼠16只,随机等分为SCI组和假术(SHAM)组。SCI组大鼠用NYU撞击器损伤L1节段脊髓,撞击力为10 g×12.5 mm。SHAM组大鼠仅切除椎板,不损伤脊髓。术后每天观察双后肢自噬现象,每周测量双后肢运动功能评分(BBB scores,developed by Basso,Beattie and Bresnahan at Ohio State University)。术后4~8周每周测量后肢触压痛痛阈及冷热过敏症状,了解CP的发生情况。术后8周每组取4只行损伤远端脊髓GAP-43与CGRP免疫荧光双标记并在共聚焦显微镜下观察二者的共定位表达情况。[结果]SCI组大鼠术后均出现双后肢瘫痪及明显的CP症状,其损伤远端脊髓背角中GAP-43与CGRP的共定位表达量明显升高,分布范围明显扩大,与SHAM组比较,差异有统计学意义(P<0.01)。[结论]CP的发生与SCI后感受伤害性刺激的CGRP阳性感觉传入纤维的出芽再生有关。

关键词(KeyWords)： 脊髓损伤(SCI);中枢性疼痛(CP);生长相关蛋白43(GAP-43);降钙基因相关肽(CGRP)

Abstract:

Keywords:

基金项目(Foundation): 全军医学科技青年培育项目计划(项目编号:13QNP027)

作者(Author): 林世德;张俊江;臧宇杰;赵廷宝;

Email:

DOI:

参考文献(References)：

• [1]Lee BB,Cripps RA,Fititzharris M,et al.The global map for traumatic spinal cord injury epidemiology:update 2011,global incidence rate[J].Spinal Cord,2014,52(2):110-116.
• [2]Saulino M.Spinal cord injury pain[J].Physic Med Rehabil Clin North Am,2014,25(2):397-410.
• [3]D'angelo R,Morreale A,Donadio V,et al.Neuropathic pain following spinal cord injury:what we know about mechanisms,assessment and management[J].Eur Rev Med Pharmacol Sci,2013,17(23):3257-3261.
• [4]Margolis JM,Juneau P,Sadosky A,et al.Health care resource utilization and medical costs of spinal cord injury with neuropathic pain in a commercially insured population in the United States[J].Arch Physic Med Rehabil,2014,95(12):2279-2287.
• [5]Xie YG,Mu HJ,Li Z,et al.Supression of chronic central pain by superoxide dismutase in rats with spinal cord injury:Inhibition of the NMDA receptor implicated[J].Exper Therap Med,2014,8(4):1137-1141.
• [6]Yang Q,Wu Z,Hadden JK,et al.Persistent pain after spinal cord injury is maintained by primary afferent activity[J].J Neurosci,2014,34(32):10765-10769.
• [7]Chaplan SR,Bach FW,Pogrel JW,et al.Quantitative assessment of tactile allodynia in the rat paw[J].J Nurosci Methods,1994,53(1):55-63.
• [8]Finnerup NB,Johannesen IL,Sindrup SH,et al.Pain and dysesthesia in patients with spinal cord injury:a postal survey[J].Spinal Cod,2001,39(5):256-262.
• [9]房龙,赵廷宝.脊髓损伤后中枢性疼痛的治疗进展[J].中国矫形外科杂志,2012,20(4):326-328.
• [10]Ondarza AB,Ye Z,Hulsebosch CE.Direct evidence of primary afferent sprouting in distant segments following spinal cord injury in the rat:colocalization of GAP-43 and CGRP[J].Exper Neurol,2003,184(1):373-380.