Objective To investigate effect of methylprednisolone( MP ) on neuron specific enolase ( NSE )expression after acute spinal cord injury during: perioperative period. Methods 45 rabbits were randomly divided into three groups. Croup 1 was made into the incomplete spinal cord injury by the method oi advanced Allen's and treated by methylprednisolone. Croup 2 got the same injury,but was treated by normal saline as contrast. Croup 3 was performed the operation of total laminoectomy and injected normal saline. Post operation managements included penicillin 400 000 U intramuscularis bis in die in the first 7 d alter surgery and artificial feeding 4 weeks. Then group 1 was administered with met hylpredni solo ne protocol 30 mg/kg bolus),the first day 10 mg,next day 8 mg and the third day 5 mg alter surgery. The group 2 and 3 were infused with the same volume of saline as contrast. Blood samples were collected in the times as follows: Pre-in-jury 1 hour,post-injury 4 h,post-injury 12 h,post-injury 24 h,post-injury 48 h,post-injury 72 h. Three rabbits were chosen randomly to check the injured spinal cord and performed wih HE stain, and immunolhisto-chemical of NSE 7 d, 14 d,28 d alter surgery. The rabbits were evaluated the motor function as the advanced Tarlov method at the time follows:pre-injury 1 hour,post-injury 2 h,post-injury 7 d,post-injury 14 d,post-injury 28 d. Results (1) MP group and the model group serum levels of NSE increased at post-injury 4 h, which reached peak value at 12 h,and back to the normal level at 48 h( P＜0.05 ). (2)MP group and model control group at 1 h before operation,2 h after operation,2 weeks after operation, the difference was not statistically significant P ＞ 0. 05 ) , after 4 weeks in the MP group Tarlov was higher than the control group, the difference was statistically significant ( P ＜ 0. 05 ). Conclusion Met hylpredni solo ne can decrease the concentration of the serum NSE and inhibit the spinal cord to deliver NSE , which can protect neuron, promote the recovery of neurological function.%目的研究围术期使用甲泼尼龙(MP)对兔急性脊髓损伤后神经元特异性烯醇化酶(NSE)表达的影响及意义.方法 将45只家兔随机分为3组,各15只,MP组:暴露脊髓后,用改良Allen′s法打击致伤脊髓,随后关闭切口;模型对照组:改良Allen′s法进行同等势能打击脊髓后关闭切口;空白对照组:暴露脊髓后,不行脊髓打击,直接关闭切口.术后连续7 d使用青霉素40×104 U肌内注射,每日2次,术后饲养4周.于术前1 h,术后12、24、48、72 h分别采血用酶联免疫吸附试验测定血清NSE.术后7、14、28 d分别取3只动物处死,取损伤段脊髓行HE染色光镜下观察脊髓形态改变及神经元改变,免疫组化检测NSE.术后2 h及7、14、28 d分别行改良的Tarlov评分,观察脊髓功能恢复情况.结果①MP组和模型对照组血清NSE在急性脊髓损伤后4 h出现明显增高,12 h达到高峰,48 h降至正常(P＜0.05).②MP组与模型对照组术前1 h、术后2 h、术后2周差异无统计学意义(P＞0.05),术后4周MP组Tarlov评分较对照组高,差异有统计学意义(P＜0.05).结论 围术期使用MP可降低急性脊髓损伤后兔血清中NSE浓度,减少损伤脊髓神经元中NSE的释放,从而保护神经元,改善神经功能.
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