甲基强的松龙治疗大鼠急性脊髓损伤后对骨密度及生物力学的影响.doc

　　甲基强的松龙治疗大鼠急性脊髓损伤后对骨密度及生物力学的影响 ：刘亦恒，张寿 ，张海英, 张小明，崔可赜 【摘要】 　　目的：观察大鼠急性脊髓损伤后大剂量甲基强的松龙（methylprednisolone，MP）冲击疗法对大鼠骨密度及生物力学的影响。方法: 46只成年健康SD大鼠随机分为对照组、模型组、 治疗 组等3组。按改良Allens法建立大鼠急性脊髓损伤模型。治疗组伤后 30min 经腹膜腔注入MP30mg／kg，以后每小时注入 MP5.4mg／kg，维持24h；模型组应用生理盐水替代 MP，处理方法同治疗组。观察模型组与治疗组大鼠在伤后1、3和6个月 BBB 运动功能评分、各组L4椎体、股骨不同部位骨密度及生物力学参数的变化。结果: 术后各时间点模型组与治疗组BBB 评分总体呈增高趋势，治疗组在各个时间点BBB 神经行为学评分均优于模型组（Plt;0.05，Plt;0.01）。术后1、3、6个月，模型组与治疗组大鼠股骨骨密度均显著下降（Plt;0.05，Plt;0.01）；术后 6 个月，与模型比较，治疗组股骨、腰椎骨密度均显著下降(Plt; 0.05)。术后6个月，对模型与治疗组大鼠的右侧股骨最大荷载、第 4腰椎结构强度均显著降低（Plt;0.01）；与模型组相比，治疗组的右侧股骨最大荷载、第 4腰椎结构强度降低，结果具有显著性差异(Plt; 0.05)。结论: 模型组及治疗组均可导致骨质疏松的发生，但大剂量MP对大鼠远期骨密度及生物力学有不利影响。 【关键词】 急性脊髓损伤；甲基强的松龙；骨质疏松；骨密度；生物力学 　　［ABSTRACT］ Objective: To investigate the effect of high dose MP on bone density and biomechanics changes after acute spinal cord injury（ASCI）．Methods: A total of 46 adult rats ly divided into three groups, namely, the control group (CG), the model group (MG), and the experimental group (EG). After anesthesia, T8 vertebrae plate resection ed to rats in both CG and EG ethod. Thirty minutes after ASCI, the subjects in experimental group received MP injection through intraperitoneal g/kg. Then a dosage of 5.4 mg/kg of MP odel group received normal saline instead of MP e method. A detection of both Basso, Beattie and Bresnahan (BBB) lootor rating scaling, bone density and biomechanics ed to the L4 vertebral body and the femur of rats 1, 3 and 6 months folloe; group EG 1, 3, 6 month (Plt; 0.05, Plt;0.01); bone density in the femur and the lumbar vertebra of rats in MG and EG deceased dramatically 1, 3, 6 months postoperatively (Plt;0.05, Plt;0.01). pared ur and the lumbar vertebra in EC deceased dramatically 6 months postoperatively (Plt;0.05). The femurs maximum load and structural strength of vertebra onths postoperatively (Plt;0.01). pared urs maximum load, the L4 vertebral structural strength maximum load (Plt;0.05). Conclusions: Both MG and EG can result in osteoporosis, but the highdose MP has