超大剂量甲泼尼龙治疗实验性变态反应性脑脊髓炎的疗效分析.pdf

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1、当代医学2015年6月第21卷第16期总第387期ContemporaryMedicine，Jun．2015，Vo1．21No．16IssueNo．387doi：10．3969／j．issn．1009-4393．2015．16．001超大剂量甲泼尼龙治疗实验性变态反应性脑脊髓炎的疗效分析危智盛黄叶青刁胜朋洪铭范【摘要】目的研究超大剂量甲泼尼龙(M尸)对实验性变态反应性脑脊髓炎(EAE)大鼠的治疗作用，探讨超大剂量M尸能否提高疗效。方法构建EAE大鼠模型，分为超大剂量组、小剂量组和模型对照组，分别予以尾静脉注射

2、MPIO0mg／kg、25mg／kg、等体积生理盐水；另取正常大鼠为正常对照组，给予等体积生理盐水注射。连续给药5d，处死大鼠，采血检测血浆自细胞介素一2(IL-2)、肿瘤坏死因子一cc(TNF-c【)含量。取脑、脊髓组织行HE染色及髓鞘染色。对临床评分、炎性病灶计数、髓鞘脱失评分、细胞因子含量等进行综合评价。结果超大剂量组和小剂量组大鼠经MP治疗前后临床评分差异均有统计学意义(P

3、病灶数、髓鞘脱失评分、细胞因子含量等方面比较均无统计学差异。结论两种剂量M尸均能缓解EAE症状，改善病情，但临床疗效并不与剂量呈依赖性，在一定的有效剂量范围内，超大剂量MP并不能提高疗效。【关键词】甲泼尼龙实验性变态反应性脑脊髓炎；糖皮质激素，白细胞介素一2；肿瘤坏死因子一a【Abstract】ObjectiveToevaluatethetherapeuticeffectsofsuper—highdoseofmethylprednisolone(MP)inexperimentalallergicencepha

4、lomyelitis(EAE)，andtoinvestigatewhetherasuper-highdoseofMPimprovesitseficacy．MethodsEAEmodelswereinducedbyWistarrats，andthentheEAEratswererandomlydividedintothreegroups(superhigh-dosegroup，low—dosegroup，andmodelcontrolgroup)．Superhigh—dosegroupandlow—dosegr

5、oupweregivenMPatadoseof100and25mg／kgi．．respectively．Modelcontrolgroupandnormalcontrolgroupswereinjectedwithanequivalentvolumeof0．9％salinesolution．Theratsweresacrificedafterfiveconsecutivedaystherapy,thentheplasmaconcentrationsofinterleukin-2(IL一2)andtunlorn

6、ecrosisfactor-a(TNF-Ⅱ)weremeasuredbyradioimmunoassay．PathologicalfeatureandmyelinofspinalcordwasobservedbyHEstainingandmyelinstainingrespectively．Theeficacyofsuperhigh·-doseandlow-·doseMPwasevaluatedbyanalyzingclinicalscorechanges，demyelinationscores，inflam

7、matorylociandthecytokineconcentrations．ResultsTheclinicalscoresofEAEratsinsuperhigh—doseandlow—dosegroupafterMPtreatmentweresignificantlylowerthanthatbeforetreatment，andthecountsofinflammatoryfoci，scoresofdemyelinationandconcentrationsofIL一2and1NF·o【insuper

8、high—doseandlow-dosegroupweresignificantlylowerthanthatinmodelcontrolgroup．However,therewerenosignificantdiferencesinthoseaspectsbetweensuperhigh—dosegroupandlow-dosegroups．ConclusionBothMPdoseshadsimi