摘要目的：研究颈交感神经阻滞（ CSB）对大鼠面神经损伤后的修复作用机制，探讨有效治疗介入时间。方法72只SD大鼠按照随机数字表法分4组，分别为假手术组（ sham组）、模型组（ NS组）、CSB1组和CSB2组，每组均18只。除假手术组外，其余组制成大鼠面瘫模型，不同时间点给予CSB治疗，观察大鼠行为变化，检测不同时期患侧面神经电图（ ENoG）及受损侧面神经核胶质细胞源性神经营养因子（ GDNF）的表达。结果 sham组、NS组、CSB1组和CSB2组大鼠面部触须运动功能评分在7 d时分别为（3.87±0.35）、（0.50±0.52）、（1.07±0.62）和（0.81±0.42）分，差异有统计学意义（F＝2.934， P＝0.035），14 d时分别为（3.85±0.37）、（0.91±0.52）、（1.57±0.65）和（1.07±0.62）分，差异有统计学意义（F＝2.537， P＝0.038），28 d时分别为（3.85±0.37）、（1.71±0.47）、（3.00±0.68）和（2.36±0.49）分，差异有统计学意义（F＝3.627， P＝0.024）。术后7 d，NS组及CSB1、CSB2组刺激面神经均未能引起面肌的兴奋；14 d时 sham 组、NS组、CSB1组和 CSB2组的LatSD分别为（1.26±0.19）、（6.67±0.36）、（4.67±0.36）和（6.17±0.36） ms，差异有统计学意义（F＝3.052， P＝0.024），AmpSD 分别为（6.42±1.93）、（2.16±1.87）、（4.16±1.80）和（3.66±1.40）mv，差异有统计学意义（F＝3.634，P＝0.021）；28 d时LatSD 分别为（1.31±0.17）、（3.17±0.19）、（1.93±0.12）和（2.60±0.22） ms，差异有统计学意义（F＝2.729， P＝0.032），AmpSD分别为（6.82±2.30）、（4.72±5.23）、（6.22±3.50）和（5.82±4.10） mv，差异有统计学意义（F＝3.827，P＝0.019）。各组GDNF表达量7 d时分别为4.67±0.81、13.52±0.58、26.17±1.01和14.86±1.03，差异有统计学意义（F＝3.637， P＝0.028），14 d时分别为5.67±0.57、24.41±2.86、26.52±1.36和25.48±1.42，差异有统计学意义（F＝2.946， P＝0.031），28 d时分别为5.37±0.92、26.64±1.68、27.38±1.66和25.69±1.99，差异有统计学意义（F＝4.273， P＝0.012）。结论大鼠面神经损伤后早期行CSB治疗可能使受损侧面神经核GDNF表达在早期增加，从而加快损伤的面神经恢复。

abstractsObjective To explore the effects of cervical sympathetic block ( CSB ) on facial nerve regeneration in rats and seek the optimal timing of treatment.Methods A total of 72 adult Sprague-Dawley rats were divided randomly into 4 groups of sham-operation (sham), model control (NS), CSB1 and CSB2 ( n=18 each).Except for sham group , the model of peripheral facial paralysis was established for three other groups.After treating facial nerves injury with CSB at different timepoints , the behavioral changes of rats were observed.Electroneurography ( ENoG) of injured nerves was performed and the expressions of glial cell derived neurotrophic factor ( GDNF) of facial nerve nucleus were detected at different stages.Results The facial whisker movement function scores in sham , NS, CSB1 and CSB2 groups were 3.87 ±0.35, 0.50 ± 0.52, 1.07 ±0.62 and 0.81 ±0.42 ( F =2.934, P=0.035) at Day 7, 3.85 ±0.37, 0.91 ±0.52, 1.57 ±0.65 and 1.07 ±0.62 ( F=2.537, P=0.038) at Day 14 and 3.85 ±0.37, 1.71 ±0.47, 3.00 ± 0.68 and 2.36 ±0.49 (F=3.627, P=0.024) at Day 28.At Day 7, LatSD and AmpSD were not detected in NS, CSB1 and CSB2 groups.However, at Day 14, the values of LatSD were (1.26 ±0.19), (6.67 ± 0.36), (4.67 ±0.36) and (6.17 ±0.36) ms, showing a significant difference (F=3.052, P=0.024) and AmpSD (6.42 ±1.93), (2.16 ±1.87), (4.16 ±1.80) and (3.66 ±1.40) mv, also a significance (F=3.634, P=0.021).And at Day 28, LatSD were (1.31 ±0.17), (3.17 ±0.19), (1.93 ±0.12) and (2.60 ±0.22) ms (F=2.729, P=0.032) and AmpSD (6.82 ±2.30), (4.72 ±5.23), (6.22 ± 3.50) and (5.82 ±4.10) mv (F=3.827, P=0.019).The expression quantities of GDNF in 4 groups produced significant differences at Day 7 (4.67 ±0.81, 13.52 ±0.58, 26.17 ±1.01 and 14.86 ±1.03, F=3.637, P=0.028), Day 14 (5.67 ±0.57, 24.41 ±2.86, 26.52 ±1.36 and 25.48 ±1.42, F=2.946, P=0.031) and Day 28 (5.37 ±0.92, 26.64 ±1.68, 27.38 ±1.66 and 25.69 ±1.99, F =4.273, P =0.012 ).Conclusion During early stage of facial nerve injury , the treatment of CSB may increase the expression of GDNF of facial nerve nucleus at early stage and thus accelerate the recovery of facial nerve injury in rats.