邵金奇,姚旌
SHAO Jinqi,YAO Jing

• 1:贵州医科大学附属医院疼痛科

摘要(Abstract)：

目的 探讨星状神经节阻滞对中枢性疼痛大鼠脊髓组织中白细胞介素-1β(IL-1β)、IL-6及肿瘤坏死因子-α (TNF-α)的影响。方法 将112只SD雄性大鼠随机均分成空白组(不予任何处理)、假手术组、模型组及治疗组，模型组和治疗组采用脊髓损伤(SCI)手术制备大鼠中枢性疼痛模型，治疗组在造模成功后立即行星状神经节阻滞，手术组仅咬除T9-T11椎板(不损伤硬脊膜);造模成功后于6 h、12 h、24 h、48 h、5 d、7 d及14 d时分别进行行为学观察和BBB评分，于5 d、7 d及14 d时进行热痛敏潜伏期(PWL)测定，并取损伤段脊髓组织采用ELISA检测脊髓中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量以及苏木精-伊红染色观察脊髓组织学改变。结果 与假手术组比较，模型组大鼠出现不同程度的自我伤害行为，PWL、BBB评分明显降低(P<0.05);与模型组比较，治疗组大鼠的自我伤害行为相对较轻，PWL、BBB评分升高(P<0.05);与假手术组比较，模型组在各时点时脊髓组织中的IL-1β、IL-6及TNF-α含量均明显升高(P<0.05);与模型组比较，治疗组大鼠脊髓组织中IL-1β、IL-6及TNF-α降低(P<0.05);HE染色结果显示，术后24 h时模型组和治疗组大鼠受损部位脊髓组织灰白质分界不清，灰质区域均可见片状出血、组织水肿及细胞核固缩，但治疗组较模型组稍轻微；术后14 d时两组大鼠受损部位脊髓组织的白质区域可见明显的坏死后形成的囊腔，但治疗组较模型组囊腔稍小。结论 星状神经节阻滞可减轻中枢性疼痛模型大鼠的脊髓损伤及改善脊髓功能，其机制可能与降低脊髓损伤局部组织中IL-1β、IL-6及TNF-α的含量有关。
Objective To explore the effect of stellate ganglion block on IL-1β, IL-6, and TNF-α in the spinal cord tissue of rats with central pain. Methods One hundred and twelve SD male rats were randomly divided into blank group(without any treatment), sham operation group, model group, and treatment group. The model group and treatment group used spinal cord injury to prepare rat central pain models; the planetary ganglion block was performed immediately after successful modeling in the treatment group, and only the T9-T11 vertebral plate was occluded in the sham operated group(without damaging the spinal dura mater); after the successful modeling, behavioral observation and BBB scores were performed at 6 h, 12 h, 24 h, 48 h, 5 d, 7 d, and 14 d, and the paw withdrawal latency(PWL) was measured at 5d, 7d and 14d, and the injured spinal cord tissue was used for ELISA to detect IL-1β,IL-6,TNF-α, and histological changes of spinal cord observed by hematoxylin-eosin staining. Results Compared with the sham operation group, rats in the model group showed different degrees of self-injury behavior, and their PWL and BBB scores were significantly reduced(P<0.05); compared with the model group, the self-injury behavior of rats in the treatment group was relatively mild, and the scores of PWL and BBB were significantly increased(P<0.05); compared with the sham operation group, the levels of IL-1β, IL-6, and TNF-α in the spinal cord tissue of the model group were significantly increased(P<0.05); compared with the model group, the levels of IL-1β, IL-6, and TNF-α in the spinal cord of rats in the treatment group decreased(P<0.05); the results of HE staining showed: on the first day after operation, the gray white matter of the injured spinal cord tissue in the model group and the treatment group was indistinct, and lamellar hemorrhage, tissue edema and nuclei consolidation were visible in the gray matter region, but the treatment group was slightly less severe than the model group; on the 14~(th) day after operation, the spinal cord tissues at the damaged site showed obvious cystic cavities formed after necrosis in the white matter region, but the cystic cavities were slightly smaller in the treated group than the model group. Conclusion Stellate ganglion block can alleviate spinal cord injury and improve spinal cord function in rats with central pain. Its mechanism may be related to the reduction of the contents of IL-1β, IL-6 and TNF-α in local tissues of spinal cord injury.

关键词(KeyWords)： 星状神经节阻滞;脊髓损伤;中枢性疼痛;细胞白介素-6;白细胞介素-1β;肿瘤坏死因子-α
stellate ganglion block;spinal cord injury;central pain;interleukin-6;interleukin-1 β;tumor necrosis factor α

Abstract:

Keywords:

基金项目(Foundation): 贵阳市医疗机构职业安全调查及健康管理(H-2020-04)

作者(Author): 邵金奇,姚旌
SHAO Jinqi,YAO Jing

DOI: 10.19367/j.cnki.2096-8388.2023.07.006

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