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N-乙酰半胱氨酸对实验性脊髓损伤的神经临床、生化及组织病理学参数的疗效:与甲基泼尼松龙的比较

Efficacy of N-acetylcysteine on neuroclinical, biochemical, and histopathological parameters in experimental spinal cord trauma: comparison with methylprednisolone.

作者信息

Çavuş U Y, Yılmaz A, Aytekin M N, Taburcu G, Albayrak A, Yıldırım S, Ağır I

机构信息

Department of Emergency Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.

Department of Emergency Medicine, Bitlis State Hospital, Bitlis, Turkey.

出版信息

Eur J Trauma Emerg Surg. 2014 Jun;40(3):363-71. doi: 10.1007/s00068-013-0349-4. Epub 2013 Nov 21.

Abstract

BACKGROUND

N-acetylcysteine (NAC) is an antioxidant agent that has been shown to have beneficial effects when treating various diseases. The aim of this study was to investigate the effects of NAC on spinal cord injury in an experimental rat model.

METHODS

A total of 48 adult male wistar albino rats were divided into six groups. Group C included the control rats, group L included the rats that underwent laminectomy, and group T included the rats in which spinal cord trauma was induced by the weight-drop method after laminectomy. Groups M (the methylprednisolone group), N (the NAC group), and MN (the methylprednisolone + NAC group) were the treatment groups. In the fourth group (group M), 30 mg/kg methylprednisolone (MP) was administered as a bolus intraperitoneally (IP), and a standard MP treatmentat a dose of 5.4 mg/kg was applied for 24 h. In the fifth group (group N), only 300 mg/kg NAC was administered as a bolus IP. In the sixth group (group MN), the standard MP treatment and a single 300 mg/kg dose of NAC were administered as a bolus IP. The motor functions of the rats were evaluated on the 1st, 7th, and 14th days using the inclined plane test defined by Rivlin and Tator and the motor scale defined by Gale et al. Spinal cord samples were obtained on the 14th day. The samples were evaluated using pathological and biochemical analysis.

RESULTS

In the neuroclinical assessment, no differences were observed between groups T and M in terms of motor improvement. However, statistically significant differences were observed between group T and groups N and MN (p < 0.001, p = 0.01, respectively). Statistically significant differences were also seen between group M and groups N and MN on the 1st and 7th days (p < 0.017, p < 0.01, respectively). Additionally, when groups N and MN were compared with groups T and M,the pathological and biochemical analyses were found to be statistically different (p < 0.05, p < 0.001, respectively).

CONCLUSION

It was concluded that NAC treatment and the combined NAC + MP treatment may be more useful for healing in rats with experimental spinal cord injury in terms of neuroclinical, pathological, and biochemical results than MP-only therapy.

摘要

背景

N-乙酰半胱氨酸(NAC)是一种抗氧化剂,已证明在治疗各种疾病时具有有益作用。本研究的目的是在实验性大鼠模型中研究NAC对脊髓损伤的影响。

方法

将48只成年雄性Wistar白化大鼠分为六组。C组为对照大鼠,L组为接受椎板切除术的大鼠,T组为椎板切除术后采用重物坠落法诱导脊髓损伤的大鼠。M组(甲基强的松龙组)、N组(NAC组)和MN组(甲基强的松龙+NAC组)为治疗组。在第四组(M组)中,以30mg/kg甲基强的松龙(MP)腹腔内推注给药,然后以5.4mg/kg的剂量进行标准MP治疗24小时。在第五组(N组)中,仅以300mg/kg NAC腹腔内推注给药。在第六组(MN组)中,进行标准MP治疗并以300mg/kg的单次剂量NAC腹腔内推注给药。在第1、7和14天使用Rivlin和Tator定义的斜面试验以及Gale等人定义的运动量表评估大鼠的运动功能。在第14天获取脊髓样本。使用病理和生化分析对样本进行评估。

结果

在神经临床评估中,T组和M组在运动改善方面未观察到差异。然而,在T组与N组和MN组之间观察到统计学上的显著差异(分别为p<0.001,p=0.01)。在第1天和第7天,M组与N组和MN组之间也观察到统计学上的显著差异(分别为p<0.017,p<0.01)。此外,当将N组和MN组与T组和M组进行比较时,发现病理和生化分析存在统计学差异(分别为p<0.05,p<0.001)。

结论

得出的结论是,就神经临床、病理和生化结果而言,NAC治疗以及NAC+MP联合治疗在实验性脊髓损伤大鼠的愈合方面可能比仅使用MP治疗更有效。

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