摘要
目的 应用运动皮层部分切除术建立猕猴痉挛型脑性瘫痪（简称脑瘫）偏瘫模型并探讨其评价方法。方法 4只3月龄猕猴采用随机数字表法随机分为健康对照组和手术模型组。健康对照组不做任何处理。手术模型组猕猴应用运动皮层部分切除术切除右侧大脑外侧裂以上至半球间裂的中央前回皮质及额上回后部（正前中沟以前0.3-0.5 cm）皮质，深度0.5-0.6 cm。术后进行连续摄像，观察有无左侧肢体运动功能障碍和动态、静态的姿势异常。徒手检查和参考应用改良人Ashworth量表评定肌张力，应用自编粗大运动及精细运动评估量表检测2组猕猴运动障碍的量化指标，运用9.4T磁共振成像（MRI）检测颅脑的影像学改变。结果 手术模型组猕猴术后立刻出现左侧肢体瘫痪，左上肢不能正常抬举，左下肢瘫痪，左侧肢体跛行明显，进食时主要以右侧肢体为主；6周后手术模型组猕猴左侧肢体的活动量低于健康对照组，粗大运动评分以及精细运动评分均明显低于健康对照组（Friedman检验：χ^2＝33.939，P〈0.05；χ^2＝37.526，P〈0.05）。手术模型组猕猴术后姿势为静止时向左侧倾斜，蹲坐于猴笼一角，左上肢搭于猴笼网上以维持姿势平衡，运动时仍向左侧倾斜，模拟出人典型的痉挛型偏瘫脑瘫的临床表现。徒手检查肌张力，手术模型组术后即出现左侧肢体瘫痪和肌张力降低，5周后左侧肌张力逐渐开始增高，并逐渐增加至评分4分，10周后评分达到3分并持续存在。术后3周头颅MRI显示右侧运动皮层切除术后疤痕组织形成，支持偏瘫脑瘫模型的影像学改变。结论 通过运动皮层部分切除术成功建立猕猴痉挛型偏瘫脑瘫模型，行为学评价及头颅MRI均表明模型符合痉挛型偏瘫情况。
Objective To establish spastic cerebral palsy model of macaque by partial resection of motor cor- tex and explore its evaluation method. Methods Four individuals of 3 - month - old macaques were divided into healthy control group and operation model group according to random number table. Partial resection of the motor cortex was carried out in operation model group, in which precentral gyms cortex from above the fight lateral cerebral fissure to the inter - hemicerebral fissure, together with the posterior - superior frontal gyms （ about 0.3 to 0.5 cm in front of the anterior median suleus） cortex were removed with the depth of about 0.5 to 0.6 cm. After the operation,the continuous camera shooting was used to record whether left limb motor dysfunction and abnormal posture existed or not. Muscle ten- sion was assessed by manual examination of muscle tone with reference to the modified Ashworth scale. The quantitative indexes of the two groups were detected by using the gross motor and fine motor assessment scale. 9.4T magnetic reso- nance imaging （MRI） was used to detect the brain imaging changes. Results After operation, the macaque in the operation model group immediately showed left hemiparesis,left upper limb abnormal lifting,left lower limb paralysis, left limb claudication, and eating mainly relied on the right side of the body. After 6 weeks of operation, left limb activity of the operation model group was significantly lower than that of the healthy control group, and the gross motor scores and fine motor scores were significantly lower than those of the healthy control group（ Friedman test： χ^2 = 33. 939 ,P 〈 0.05 ;χ^2 = 37. 526 ,P 〈 0.05 ）. The macaque in the operation model group showed some symptoms that abnormal posture mainly tilted to the left for the rest, sitting in a comer of the monkey cage, left arm was put on the cage to maintain pos- tural balance, and movement was left slightly inclined, which had simulated the typical clinical manifestations of human spastic hemiplegic
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2017年第11期861-864,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
国家科技支撑计划项目（2014BA103BOO）
国家自然科学基金青年基金（31501866）
关键词
猕猴
脚I生瘫痪
动物模型
痉挛性偏瘫
脑损伤
Macaaue ： Cerebral palsy- Animal model： Soastic cerebral t）alsv ： Brain iniurv
