中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (23): 3767-3772.doi: 10.12307/2021.052

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    

急性钳夹型脊髓损伤模型大鼠造模方式的选择：一项网状Meta分析

徐伟龙1，左  媛2，辛大奇2，贺晨阳1，赵  鹏1，史  鸣1，周博源1，刘雅婷1，赵  岩2   

  1. 1内蒙古医科大学，内蒙古自治区呼和浩特市   010000；2内蒙古医科大学第二附属医院，内蒙古自治区呼和浩特市   010000
  • 收稿日期:2020-04-09 修回日期:2020-04-16 接受日期:2020-09-11 出版日期:2021-08-18 发布日期:2021-02-24
  • 通讯作者: 赵岩，教授，硕士生导师，内蒙古医科大学第二附属医院胸腰椎脊柱外科，内蒙古自治区呼和浩特市 010000
  • 作者简介:徐伟龙，男，1992年生，内蒙古自治区呼和浩特市人，汉族，内蒙古医科大学在读硕士，主要从事急性脊髓损伤研究。
  • 基金资助:
    内蒙古自治区科技计划项目(2019GG157)，项目负责人：左媛

Selection of modeling methods for acute compressive spinal cord injury: a network Meta-analysis

Xu Weilong1, Zuo Yuan2, Xin Daqi2, He Chenyang1, Zhao Peng1, Shi Ming1, Zhou Boyuan1, Liu Yating1, Zhao Yan2   

  1. 1Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China; 2The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • Received:2020-04-09 Revised:2020-04-16 Accepted:2020-09-11 Online:2021-08-18 Published:2021-02-24
  • Contact: Zhao Yan, Professor, Master’s supervisor, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • About author:Xu Weilong, Master candidate, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • Supported by:
    the Scientific Research Project of Inner Mongolia Autonomous Region, No. 2019GG157 (to ZY)

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摘要：

文题释义：
急性脊髓损伤：是脊柱损伤中一种较为严重的中枢神经系统并发症，常会导致损伤节段以下肢体感觉、运动、反射及自主神经等功能的部分和完全丧失。
常见的急性脊髓损伤模型：包括压迫型、挫伤型、横断型、缺血型和牵张型脊髓损伤动物模型。

目的：用动脉瘤夹创建急性钳夹型脊髓损伤模型是一种简单有效的造模方法。然而，为了建立这种急性钳夹型脊髓损伤动物模型，许多实验根据不同闭合力的动脉瘤夹和压迫时间采用了不同的造模方式，其中包括30 g压迫力的动脉瘤夹压迫脊髓60 s (30 g，60 s组)；70 g压迫力的动脉瘤夹压迫脊髓30 s (70 g，30 s组)；70 g压迫力的动脉瘤夹压迫脊髓60 s (70 g，60 s组)；动脉瘤夹压迫脊髓至其直径的1/2，压迫时间为30 s (1/2，30 s组)。文章的目的是探讨这4种造模方式是否存在显著性差异，并且找出最适合创建急性钳夹型脊髓损伤模型的方法。
方法：计算机检索PubMed、Embase、中国知网、维普和万方数据库等数据库截止2019-10-01公开发表的关于急性脊髓损伤大鼠造模的文献。依据设定的纳入排除标准对文献进行筛选，并对纳入的文献进行数据提取和质量评价。最后运用RevMan软件和ADDIS软件，采用Meta分析、亚组分析和网状Meta分析的方法评价不同建模方法对脊髓损伤大鼠肢体功能的影响。
结果：①共纳入14篇文献质量评价为6-8分的随机对照动物实验，共包含714只SD大鼠；②Meta分析结果显示，术后第1周，各造模方式的BBB评分排序结果依次为：假手术组>30 g，60 s组>1/2，30 s组>70 g，60 s组>70 g，30 s组，其中用30 g闭合力的动脉瘤夹压迫脊髓60 s组在术后第1周的BBB评分最高，明显高于其他3组(P < 0.05)；③亚组分析结果提示，急性脊髓损伤的运动恢复与大鼠性别有关，大鼠昼夜活动的差异影响BBB评分的测定。
结论：文章阐述的4种造模方法都可构建急性钳夹型脊髓损伤动物模型，以运动功能恢复方面为判断标准时，用30 g闭合力的动脉瘤夹压迫脊髓60 s是目前已发表文献所显示的最佳造模方法，同时建议使用雌性大鼠进行造模，但未来还需进一步研究验证。

https://orcid.org/0000-0001-7583-4681(赵岩) 

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 脊髓损伤, 模型, 动脉瘤, 大鼠, 运动恢复, 性别, 网络Meta分析, 循证医学

Abstract: OBJECTIVE: Generating an acute compressive spinal cord injury model with an aneurysm clip is a simple and effective modeling method. However, to create the animal model of acute compressive spinal cord injury, many experimental studies have utilized diverse modeling methods according to different closure force aneurysm clips and duration, including aneurysm clipping with 30 g compression force to compress the spinal cord for 60 seconds (30 g, 60 s); aneurysm clipping with 70 g compression force to compress the spinal cord for 30 seconds (70 g, 30 s); aneurysm clipping with 70 g force to compress the spinal cord for 60 seconds (70 g, 60 s); compressing the spinal cord to 1/2 of its diameter for 30 seconds by aneurysm clips (1/2, 30 s). The present study aimed to assess whether there is a significant difference among these modeling methods, and to determine the method that is most suitable to establish the clamp-type spinal cord injury model.
METHODS: A literature search of PubMed, Embase, CNKI, VIP, and WanFang databases was conducted for relevant studies from their inception dates to October 1, 2019. The included literatures were initially screened according to the inclusion and exclusion criteria, and data extraction and quality evaluation were performed subsequently. The paired Meta-analysis, subgroup analysis, and network Meta-analysis were conducted to evaluate the effects of different modeling methods on the limb function of spinal cord injury rats.
RESULTS: Fourteen articles with a total of 714 Sprague-Dawley rats were included in the study. All the included articles were scored 6-8 for quality evaluation. The Basso, Beattie and Bresnahan (BBB) scores of the four modeling methods in the 1st week after modeling ranked as follows: sham operation group > 30 g, 60 s group > 1/2, 30 s group > 70 g, 60 s group > 70 g, 30 s group. The BBB score in the 30 g, 60 s group was significantly higher than that in the 1/2, 30 s group, 70 g, 60 s group and 70 g, 30 s group at 1 week postoperatively (P < 0.05). Subgroup analyses suggested an association of locomotor recovery of spinal cord injury with the sex of rats. Differences in circadian activities of rats also affected the BBB scores.
CONCLUSION: The four modeling methods described in the study can be used to create the animal model of acute compressive spinal cord injury. Comparison of the four modeling methods has revealed that the best way to create a clamp-type spinal cord injury model is to compress the spinal cord for 60-second aneurysm clipping with a closing force of 30 g. It is recommended to use female rats for modeling, but further research and verification are needed.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: spinal cord injury, model, aneurysm, rat, locomotor recovery, sex, network Meta-analysis, evidence-based medicine

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