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糖皮质激素治疗对早期运动神经变性过程中神经肌肉传递的有益作用。

Beneficial action of glucocorticoid treatment on neuromuscular transmission during early motor nerve degeneration.

作者信息

Hall E D, Riker W F, Baker T

出版信息

Exp Neurol. 1983 Feb;79(2):488-96. doi: 10.1016/0014-4886(83)90228-5.

Abstract

The effects of a short-term, high-dose glucocorticoid pretreatment regimen (triamcinolone diacetate, 8 mg/kg i.m. daily for 7 days) were examined on neuromuscular transmission deficits observed in the in vivo cat soleus nerve-muscle preparation at 48 hr after soleus nerve transection. The pretreated preparations had 20% more functional motor nerve terminals than the untreated. This was evidenced by a significantly (P less than 0.01) lesser difference in the indirectly evoked isometric contractile tensions between the denervated muscle and the contralateral intact preparation as a result of prior glucocorticoid treatment. The glucocorticoid pretreatment also significantly improved the capacity of the trophically deprived soleus motor nerve terminals to maintain transmission during high-frequency activation (100 to 400 Hz for 10 s). Moreover, triamcinolone treatment before nerve transection completely prevented the development of an increased sensitivity to d-tubocurarine neuromuscular block in untreated, 48-h nerve-transected preparations. These results demonstrate an ability of an intensive high-dose glucocorticoid treatment to sustain single and repetitive neuromuscular transmission during early anterograde nerve degeneration.

摘要

研究了短期、高剂量糖皮质激素预处理方案(双醋酸曲安奈德,每日8mg/kg肌肉注射,共7天)对在比目鱼肌神经切断术后48小时的体内猫比目鱼肌神经-肌肉标本中观察到的神经肌肉传递缺陷的影响。预处理的标本比未处理的标本具有多20%的功能性运动神经末梢。这一点可通过先前糖皮质激素治疗后,失神经支配肌肉与对侧完整标本之间间接诱发的等长收缩张力差异显著减小(P小于0.01)得到证明。糖皮质激素预处理还显著改善了营养缺乏的比目鱼肌运动神经末梢在高频激活(100至400Hz,持续10秒)期间维持传递的能力。此外,在神经切断前进行曲安奈德治疗完全阻止了未处理的、神经切断48小时的标本中对d-筒箭毒碱神经肌肉阻滞敏感性增加的发展。这些结果表明,强化高剂量糖皮质激素治疗能够在早期顺行性神经变性期间维持单次和重复性神经肌肉传递。

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