颈交感神经切断对臂丛神经节神经肽Y含量及前肢痉挛影响的实验研究 交感和副交感神经口诀

　　[摘要] 目的 探讨臂丛神经内神经肽Y含量与痉挛骨骼肌之间的关系。 方法 将16只右侧大脑皮层损伤模型Wistar大白鼠随机分成两组（各8只），实验组行颈上节交感神经切断术，对照组不予任何处理。于术后第20天对各动物相同切取相同部位左臂丛神经组织，用免疫组织化学方法检测其神经肽Y（NPY）百分率并做定量分析。同时观察左前肢术后神经症状和进行屈肘肌群痉挛评定。 结果 实验组大鼠左臂丛神经内NPY含量明显低于对照组，差异有统计学意义（P < 0.05）；大部分实验组动物患肢神经症状改善。 结论 交感神经切断术治疗大脑损伤性肌痉挛的机制可能与降低神经局部的NPY含量有关。
　　[关键词] 交感神经；臂丛神经；神经肽Y；骨骼肌
　　[中图分类号] R563 [文献标识码] A [文章编号] 1673-7210（2012）07（a）-0033-03
　　Experimental study about contribution of sympathetic nerve amputation to neuropeptide Y content in brachial plexus and spasmodic muscles in foreleg
　　HUANG Xiaowei WU Shanpeng HUANG Li LU Yizhe
　　Department of Orthopaedics, the Affiliated First Hospital of Quanzhou City, Fujian Medical University, Fujian Province, Quanzhou 362000, China
　　[Abstract] Objective To study the relationship between the neuropeptide Y content (NPY) in brachial plexus and spasmodic muscles. Methods 16 Wistar rat models that were injured on right cerebral cortex were diveded into two groups (8 rats in each group): the experiment group were operated superior cervical sympathectomy, while the control group were not treated. The same left brachial plexus tissue of each rats were removed through sympathectomy on 20th day; then the NPY percentage was examined and quantitative analysis was made through immunohistochemical method. Meanwhile, the nerve symptom was observed and the spasm of flexion elbow muscles on left foreleg was assessed after sympathectomy. Results The NPY content of left brachial plexus was significantly lower in experiment group than control group (P < 0.05). The nerve symptom of the affected limbs was improved in most of experiment group rats after sympathectomy. Conclusion The treatment mechanism of sympathectomy for myospasm resulting from cerebrum injury may be related to the decrease of local content of NPY.
　　[Key words] Sympathetic nervous; Brachial plexus; NPY; Muscle
　　临床上，许多中枢神经系统疾病可导致肢体肌肉痉挛性瘫痪，虽然缓解肌肉痉挛的方法包括中国针灸、按摩和中药，现代康复中的神经发育疗法、神经阻滞、肉毒素注射等，但其治疗相当困难，且疗效不一，对其机制研究也多从中枢控制理论和神经肌肉接头信号传递角度考虑，而对外周神经内部自身的神经肽类成分与肌痉挛关系的研究甚少。因此，本实验对大脑皮质损伤大鼠模型进行颈上节交感神经切断后，观察其臂丛神经内神经肽Y（neuropeptide Y，NPY）的改变，结合动物前肢活动和痉挛情况，分析臂丛神经中NPY与肢体骨骼肌痉挛之间的关系，探讨交感神经切断治疗肌痉挛的机制。
　　1 材料与方法
　　1.1 动物脑性瘫痪肢体痉挛模型的建立
　　参考Wright等[1]方法，简述步骤如下：将16只Wistar大鼠以戊巴比妥钠（300 mg/kg）腹腔麻醉后，采用改良的DeGroot定位系统，卧位固定大鼠于脑立体定位器上；在大鼠颅顶矢状缝作纵行切口，暴露前囟后6.6 mm，矢状缝右侧1.0 mm，用小型电钻在颅板上钻孔，直径约2.0 mm；将阳极针电极（直径0.5 mm）垂直插入9.7 mm，阴极接鼠尾，通直流电刺激以毁损椎体束，刺激后拔出电极，关闭切口。用10％活力碘消毒，缝合创口。
　　1.2 动物分组及颈上节交感神经切断
　　将造成模型的大鼠20只，雌雄各半，随机分成两组，每组雌雄各5只，于模型建立后第5天，在两组大鼠中随机选择一组，在手术显微镜下行患侧颈上节交感神经切断，另一组作为对照组。