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乙酰-L-肉碱在实验性慢性压迫性神经病变中的神经保护作用。一项前瞻性、随机、安慰剂对照试验。

Neuroprotective effects of acetyl-L-carnithine in experimental chronic compression neuropathy. A prospective, randomized and placebo-control trials.

作者信息

Kotil Kadir, Kirali Mehmet, Eras Mustafa, Bilge Turgay, Uzun Hafize

机构信息

Haseki Educational and Research Hospital, Neurosurgery Clinic, Istanbul, Turkey.

出版信息

Turk Neurosurg. 2007 Apr;17(2):67-77.

Abstract

OBJECTIVE

We designed this experimental study to examine the potential positive influences of the acetylated derivative of acetyl-L-carnithine, an endogenous substance present in the nervous system, on chronic compression neuropathy. This is the first study ever published on the medical treatment of experimental chronic compression neuropathy.

MATERIALS AND METHODS

Five groups composed of 5 rats each were used in the study. Group 1: The control group, in which a 1 cm-long segment proximally from the bifurcation point of the right sciatic nerve of each rat was excised, accompanied by removal of the right soleus muscle. Group 2: The compression neuropathy model group, in which the right sciatic nerve of each rat was compressed for 30 days. Group 3: The right sciatic nerves were compressed for 30 days, followed by decompression and assessment on the 60th day. Group 4: The right sciatic nerves were compressed for 30 days, followed by decompression and acetyl-Lcarnithine administration between days 30 and 60. Group 5: The right sciatic nerves were compressed for 30 days, followed by acetyl-L-carnithine administration from day 30 to 60 without decompression. The study continued with the rats in the other 3 groups. Rats in the 3rd group were treated with decompression only and kept for another 1 month. Rats in the 4th group received acetyl-L-carnithine at a dose of 20 mg/kg/day intraperitoneally for 1 month after decompression, whereas rats in the 5th group received only intraperitoneal acetyl-L-carnithine at a dose of 20 mg/kg/day without decompression. Like the rats in groups 1 and 2, these rats were also sacrificed with ether overdose, with their right sciatic nerves and soleus muscles being excised for histopathological examination and weighing, respectively.

CONCLUSION

In our study, it was found that decompression significantly improves the recovery rate of peripheral nerve as compared with that without decompression, and that acetyl-L-carnithine coadministered with decompression enhances clinical and histopathological recovery. In addition, the use of silicon tubes in such experiments was found to be likely to have prominent advantages.

摘要

目的

我们设计了这项实验研究,以检验乙酰 - L - 肉碱(一种存在于神经系统的内源性物质)的乙酰化衍生物对慢性压迫性神经病变的潜在积极影响。这是有史以来发表的第一项关于实验性慢性压迫性神经病变药物治疗的研究。

材料与方法

该研究使用了五组大鼠,每组5只。第1组:对照组,切除每只大鼠右坐骨神经分叉点近端1厘米长的神经段,并切除右比目鱼肌。第2组:压迫性神经病变模型组,每只大鼠的右坐骨神经被压迫30天。第3组:右坐骨神经被压迫30天,然后在第60天进行减压和评估。第4组:右坐骨神经被压迫30天,然后在第30天至第60天进行减压并给予乙酰 - L - 肉碱。第5组:右坐骨神经被压迫30天,然后在第30天至第60天给予乙酰 - L - 肉碱,不进行减压。对其他3组大鼠继续进行研究。第3组大鼠仅接受减压治疗,并再饲养1个月。第4组大鼠在减压后腹腔注射剂量为20mg/kg/天的乙酰 - L - 肉碱,持续1个月,而第5组大鼠仅腹腔注射剂量为20mg/kg/天的乙酰 - L - 肉碱,不进行减压。与第1组和第2组大鼠一样,这些大鼠也通过过量乙醚麻醉处死,分别切除其右坐骨神经和比目鱼肌进行组织病理学检查和称重。

结论

在我们的研究中,发现与未减压相比,减压显著提高了周围神经的恢复率,并且减压联合使用乙酰 - L - 肉碱可增强临床和组织病理学恢复。此外,发现在此类实验中使用硅胶管可能具有显著优势。

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