神经肌肉功能重建术式对大鼠肱二头肌生物学功能影响的实验研究

关键词：靶向肌肉神经功能重建  外周神经功能重建  靶向神经功能替代  肌萎缩

Keywords:targeted muscle reinnervation  peripheral nerve function reconstruction  targeted nerve functional replacement  muscle atrophy phenomenon

摘要：

      摘要 目的：分析靶向肌肉神经功能重建术（TMR）和靶向神经功能替代术（TNFR）对大鼠肱二头肌生物学功能的影响。 方法：SPF级SD大鼠随机分为两组，分别离断尺神经和肌皮神经，一组将尺神经的近端植入肱二头肌构建TMR动物模型，另一组将已离断的尺神经近端与肌皮神经远端吻合，构建TNFR动物模型。通过检测肱二头肌肌张力，计算肌湿重维持率，进行运动终板染色等方式评价两种手术模式的应用效果。 结果：①TNFR组肱二头肌的最大单收缩力（12.17±5.03）g明显高于TMR组肱二头肌的最大单收缩力（3.00±1.54）g（P＜0.05）；②TNFR组的肌湿重维持率（1.02±0.09）g高于TMR组（0.78±0.22）g（P＜0.05）；③两组模型均能染出运动终板，但是TNFR组运动终板数量（8.17±1.47）较TMR组数量（3.00±1.79）多（P＜0.05）。 结论：相较于TMR模型，TNFR模型能够减缓肌肉因失神经支配而出现的肌萎缩现象，更加有效支配肱二头肌。

Abstract:

      Abstract Objective: To analyze the effects of targeted muscle reinnervation(TMR) and targeted nerve functional replacement(TNFR) on the biological function of biceps brachii of SD rats. Method: Musculocutaneous nerve and the ulnar nerve were divided for all rats. In one group, proximal ulnar nerve implantation of the biceps was used to construct the TMR model. In the other group, proximal ulnar nerve and distal musculocutaneous nerve anastomosis was executed to build TNFR model. 3 months later, we checked the tension and wet weight of muscle of biceps brachii, calculated the wet weigh maintenance rate and dyed the motor end-plate to analyze the effect of the two models. Result: ①The maximal single contractile force of the bicep of the TNFR group (12.17±5.03)g was significantly higher than that of the TMR group (3.00±1.54)g (P＜0.05); ②The wet weight maintenance rate of the TNFR group (1.02±0.09) was significantly higher than that of the TMR group (0.78±0.22) (P＜0.05); ③Both groups of models were able to stain the motor end plates, but the number of motor end-plates in the TNFR group (8.17±1.47) was greater than the number of TMR group (3.00±1.79) (P＜0.05). Conclusion: Compared with the TMR model, TNFR model can slow down the muscle atrophy due to denervation, and control the biceps more effectively.