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脊髓实验性损伤的治疗研究。IV. 大剂量甲基强的松龙

Therapy study on the experimental injury of spinal cord. IV. High doses of methyl-prednisolone.

作者信息

Anghelescu N, Petrescu A, Alexandrescu I

机构信息

Institute of Neurology and Psychiatry, Bucharest.

出版信息

Rom J Neurol Psychiatry. 1995 Jul-Dec;33(3-4):241-9.

PMID:8729180
Abstract

The effect of large glucocorticosteroid hormones administered to two groups of adult rabbits with an experimental acute injury of the spinal cord was studied. In the former (10 rabbits), each animal received intravenous 30 mg/kg body weight of prednisolone-21-sodium-hemisuccinate after 30 minutes and further 15 mg/kg b.w. at intervals of 2, 24 and 48 hours since injury. In the latter (40 rabbits), each animal received 15 mg/kg b.w. methyl-prednisolone-21-hydrogen-sodium-hemisuccinate at 30 min, 2, 24 and 48 h postinjury. A group of 20 injured rabbits with the same experimental conditions was used as controls without glucocorticoid treatment. Clinically, both treated groups of rabbits showed a significant improvement of posterior limb movements and in the general state of health compared with the controls. The mean motor score (according to a 5-score scale) indicated a significant difference between the two treated groups (2.3 and 2.6, respectively and 1.7 for the controls). Histologically, the modifications correlated with the clinical posttraumatic symptomatology and severity in all the three groups: histopathological modifications consisted in oedema, ischaemic cells, diffuse microglial hyperplasia, microhaemorrhages, all of them located in the central gray matter. In all cases with a severe clinical evolution (score of 1-3), aggravated histopathological modifications both in the gray and white matter are evidenced: necrosis; vacuolization; cavitation; myelinic and axonal fragmentation, demyelination, mesenchymo-glial scar reaction. In all groups, regenerated nervous fibres were noticed in the dense scar of the injured cord.

摘要

研究了给两组成年兔静脉注射大剂量糖皮质激素对实验性急性脊髓损伤的影响。在第一组(10只兔子)中,每只动物在伤后30分钟静脉注射30mg/kg体重的琥珀酸氢化泼尼松龙-21-钠,此后在伤后2、24和48小时每隔一定时间再静脉注射15mg/kg体重。在第二组(40只兔子)中,每只动物在伤后30分钟、2、24和48小时静脉注射15mg/kg体重的甲泼尼龙-21-氢-钠-半琥珀酸酯。选取20只在相同实验条件下受伤的兔子作为未接受糖皮质激素治疗的对照组。临床上,与对照组相比,两个治疗组兔子的后肢运动和整体健康状况均有显著改善。平均运动评分(采用5分制)显示两个治疗组之间存在显著差异(分别为2.3和2.6,对照组为1.7)。组织学上,三组的改变均与创伤后临床症状和严重程度相关:组织病理学改变包括水肿、缺血细胞、弥漫性小胶质细胞增生、微出血,所有这些均位于中央灰质。在所有临床进展严重(评分为1 - 3分)的病例中,灰质和白质均出现加重的组织病理学改变:坏死;空泡化;空洞形成;髓鞘和轴突断裂、脱髓鞘、间充质-胶质瘢痕反应。在所有组中,在损伤脊髓的致密瘢痕中均发现了再生神经纤维。

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