肌肉內注射藥物引發肌肉病變之實驗研究

Experimental Myopathy Induced by Intramuscular Injection of Neurotropic Drugs

莊艷凰(Yen-Hwang Chuang) ； 李正淳(Jeng-Chum Lee) ； 陳順勝(Shun-Sheng Chen)

《The Kaohsiung Journal of Medical Sciences》 1卷6期 (1985/06) Pp. 343-349

https://doi.org/10.6452/KJMS.198506.0343

摘要

本研究在觀察肌肉內注射藥物後所引發的病理變化。選擇成熟雄性大白鼠54隻為實驗對象。均分為以下6組後分別注射不同的親神經藥物，即pentazocine（A組）、phenytoin（B組）、diazepam （C組）、phenobarbital（D組）、paraldehyde（E組）及做為控制群的normal saline（F組）。每組於左側腓腸肌內上方肌肉注射0.l ml後於1天、10天、28天後分別選出三隻，取其注射部位之肌肉，製成冷凍切片後觀查肌肉之病理變化。結果顯示在注射一天後六組均出現肌肉細胞間水腫、壞死、吞噬現象及炎性反應。注射10天後A、B、C、D、E五組開始出現再生現象及中央核，肌纖維萎縮，肌細胞和肌束周圍纖維化，但F組已完全恢復，A、B、E組肌細胞壞死及炎性反應仍繼續在進行。注射28天後A、B、C、D、E五組仍出現中央核肌細胞萎縮、肌纖維及肌束萎縮，與肌細胞和肌束周圍纖維化，E組再生現象仍繼續存在。本研究指示肌肉注射所引發的肌肉病變和針刺物理性傷害，組織局部缺血及藥物之組織毒性反應有密切之關係。同時證實肌肉注射會引起肌肉損傷而造成纖維化。

並列摘要

In order to observe the pathologic changes after intramuscular injection, we have performed the following experiment. Fifty- four mature Wista rats were divided into 6 equal groups. The drug was injected into the right gastrocnemius. The rats of Group A were injected with pentazocine; group B, diphenyhydantoin; group C, diazepam; group D, phenobarbital; group E, paraldehyde and group F with normal saline. Specimens from injected muscles were obtained for histologic examination. The course of histologic changes in different groups is shown as follows: on the first day, interstitial edema, endomysial inflammation, phagocytosis and necrosis of the muscle fibers were seen in all specimens, most in groups A and E, least in group F. Hemorrhages were present in one third of the rats. On the 10th day, complete recovery was found in group F. In another groups, there was no evidence of hemorrhage. Tissue necrosis, phagocytosis and inflammatory reaction were diminished. Groups of atrophic fibers with centrally located nuclei and an increase of endomysial connective tissue appeared. The regenerating fibers were present discretely near necrotic or degenerating muscle fibers. On the 28th day, no muscle fiber ncerosis, phagocytosis or endomysial inflammation were shown. The most common changes were increased fibers with centrally located nuclei and perifascicular fiber atrophy. In conclusion, intramuscular injection could induce myopathic changes. The muscle lesions were most likely due to the combination of needle trauma, local ischemia and histotoxicity of drugs.

並列關鍵字

injection myopathy ； neurotropic drugs ； muscular fibrosis