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糖皮质激素对坐骨神经分支选择性损伤大鼠神经病理性疼痛的影响 王秋石1，王铁东2，王俊科1 （1.中国医科大学 附属第一医院麻醉科，辽宁 沈阳 110001；2. 辽宁中医学院 附属医院麻醉科，辽宁 沈阳 110032 ） 摘要: 目的 观察糖皮质激素对大鼠坐骨神经分支选择性损伤（SNI）所至神经病理性疼痛的影响。方法 将80只雄性SD大鼠随机分四组：假手术组（Sh）；模型组（S）；鞘内注射得宝松组（D1）及局部注射得宝松组（D2）。其中S组和D1组造模后分别单次鞘内注射盐水20μl和得宝松40μg/20μl；D2组造模后单次鞘内注射盐水20μl，同时于神经损伤的局部单次注射得宝松1mg/1ml。记录全组动物术前1天及术后1、3、7、14天的机械缩足反射阈值（MWT ）和热缩足反射维持时间（TWD），并在术后各时点随机选5只大鼠，取脊髓腰膨大，用免疫组化法检测星形胶质细胞酸性纤维蛋白（GFAP）和糖皮质激素受体（GR）的表达，同时用免疫印迹法检测GR蛋白量的变化，用ELISA法检测TNF-α和IL-1β含量的变化。结果 S组术后出现明显的MWT下降和TWD延长，与术前及Sh组术后各时点比较有显著性差异（P0.01），与S和D1组比较D2组行为学指标的变化幅度小（P0.05）。S组GFAP和GR的表达量及TNF-α和IL-1β的含量术后均增加，与Sh组比较差异有统计学意义（P0.01）；D1和D2组GFAP及TNF-α和IL-1β的含量升高的幅度小，与S组比较有统计学差异（P0.05）；D2组GR的表达量升高最明显，与S和D1组比较有统计学差异（P0.05）。结论 糖皮质激素能抑制SNI大鼠脊髓星形胶质细胞的激活和炎性介质的释放；局部使用激素对脊髓内GR的影响小，且能改善SNI大鼠神经病理性疼痛。 关键词: 糖皮质激素受体；神经病理性疼痛；星形胶质细胞  Effect of glucocorticoid on the neuropathic pain of the spare nerve injury rat model Abstract:　Objective 　To investigate the effect of glucocorticoid on the neuropathic pain of the spare nerve injury (SNI)rat model. Methods Eighty male SD rats were randomly divided into four groups : GroupⅠsham-operated group(Sh); Group ⅡSNI model group(S).The rats were made SNI model, then were intrathecally injected normal saline 20μl immediately; Group Ⅲ intrathecal betamethasone(Diprospan)group(D1).It was the same as Group Ⅱ with intrathecal injection of Diprospan 40μg(20μl); Group Ⅳ local Diprospan group(D2). It was the same as Group Ⅱ with local injection of Diprospan 1mg(1ml). Mechanical withdraw threshold(MWT) and thermal withdraw duration(TWD) of the rat’s were measured with Von Frey hair or Hargreaves tests at 1 day before operation and 1,3,7,14 days after operation. We randomly choiced 5 rats in each groups separately on the 1 th 3th,7 th,14th days after operation and removed L4,5 segments of their spinal cord to assess the expression of glial fibrillary acid protein(GFAP) and glucocorticoid receptors(GRs) by immunohistochemical analysis, and the expression of TNF-αand IL-1β by ELISA metho