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4-氨基吡啶和甲基强的松龙对面神经挤压伤恢复的影响。

The effects of 4-aminopyridine and methylprednisolone on recovery of the facial nerve crush injury.

机构信息

Department of Otorhinolaryngology/Head and Neck Surgery, Tunceli State Hospital, Tunceli-Elazığ Street, Tunceli Devlet Hastanesi, 2th Florr, Tunceli, 62000, Turkey.

Department of Otorhinolaryngology/Head and Neck Surgery, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2021 Aug;278(8):3057-3063. doi: 10.1007/s00405-020-06483-w. Epub 2020 Nov 23.

Abstract

OBJECTIVE

4-Aminopyridine (4-AP) is a potassium channel blocker that enhances nerve excitability. In this study, rat models that have facial nerve crush injury (FNCI) were grouped and treated with methylprednisolone (MP), 4-AP, and a combination of these two drugs. Electrophysiologic and histopathologic outcomes of these groups will be compared with a control group.

MATERIALS AND METHODS

Thirty healthy male Wistar rats (mean weight of 265 g) were used in this study. The rats were randomly divided into five groups with six subjects in each: Group 1 (sham group), Group 2 (control group), Group 3 (MP group), Group 4 (4-aminopyridine group), and Group 5 (4-AP + MP group). All groups except the sham group underwent crush injury to the right facial nerve. Electrophysiologic and histologic recovery was recorded three weeks postoperatively.

RESULTS

The 4-AP group and the combined group had a more significant recovery at Nerve Excitability Thresholds (NET) at the end of three weeks. The methylprednisolone group and the control group had a minimal recovery of NET. Histologically, when compared with the control group, the combined group was the only group that had significant recovery at all three of axonal degeneration, axon diameter, and myelin thickness.

CONCLUSION

In this experimental study, we demonstrated that a combination treatment of 4-AP and MP is more effective in the recovery of peripheric FNCI than in the no-treatment control group and in the 4-AP- or MP-alone groups. Moreover, our results suggested that 4-AP can be a potent alternative to MP in the treatment of the FNCI.

LEVEL OF EVIDENCE

N/A.

摘要

目的

4-氨基吡啶(4-AP)是一种钾通道阻滞剂,可增强神经兴奋性。在这项研究中,面神经挤压损伤(FNCI)的大鼠模型被分为几组,分别用甲泼尼龙(MP)、4-AP 和这两种药物的组合进行治疗。将比较这些组与对照组的电生理和组织病理学结果。

材料和方法

本研究使用了 30 只健康雄性 Wistar 大鼠(平均体重 265g)。这些大鼠被随机分为五组,每组 6 只:第 1 组(假手术组)、第 2 组(对照组)、第 3 组(MP 组)、第 4 组(4-AP 组)和第 5 组(4-AP+MP 组)。除假手术组外,所有组均对右侧面神经进行挤压损伤。术后 3 周记录电生理和组织学恢复情况。

结果

在第 3 周末,4-AP 组和联合组的神经兴奋性阈值(NET)恢复更显著。MP 组和对照组的 NET 恢复最小。组织学上,与对照组相比,联合组是唯一在轴突变性、轴突直径和髓鞘厚度三个方面均有显著恢复的组。

结论

在这项实验研究中,我们证明了 4-AP 和 MP 的联合治疗在外周 FNCI 的恢复中比无治疗对照组和单独使用 4-AP 或 MP 的组更有效。此外,我们的结果表明,4-AP 可以作为 MP 治疗 FNCI 的有效替代药物。

证据水平

N/A。

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