大鼠脊髓损伤后早期应用孕酮联合减重步行训练的干预作用  

Effects of Progesterone and Body Weight Support Treadmill Training on Rats of Spinal Cord Injury

作　　者：卢节平[1] 柯先金[1] 姜婧[1] 王选[1] 徐冬晨[2] 丁新生[1] 

机构地区：[1]南京医科大学第一附属医院神经内科,南京210029 [2]南京特殊教育职业技术学院康复系,南京210038

出　　处：《神经损伤与功能重建》2009年第6期384-387,404,共5页Neural Injury and Functional Reconstruction

基　　金：国家自然科学基金项目(30671018)

摘　　要：目的:观察早期应用孕酮和减重步行训练对大鼠脊髓损伤(SCI)后的运动功能、脊髓形态学及脑源性神经营养因子(BDNF)mRNA表达的影响。方法:120只雄性SD大鼠随机分成假手术组、模型组、孕酮组、训练组、联合组(孕酮+训练),前三组各30只大鼠(每组分为第1、3、7、14、21、28天6个亚组各5只),后两组各15只大鼠(每组分为第14、21、28天3个亚组各5只);采用改良的Allen’s撞击法制成SCI模型;孕酮在术后30 min、6 h、24 h、48 h、72 h时以4 mg/kg的剂量腹腔注射;减重步行训练在术后1周开始,训练14 d;术后不同时间点采用BBB法进行后肢运动功能评分,HE染色观察脊髓形态学的变化,RT-PCR法检测BDNF mRNA的表达水平。结果:孕酮和训练均可促进大鼠后肢功能恢复和受损脊髓的出血吸收、神经再生,并且具有协同效应。RT-PCR结果显示假手术组BDNF mRNA低表达;模型组在3 d内升高;孕酮组在1周内高表达,高峰在第3天;训练组从第14天开始表达明显增高,训练停止1周后仍维持在高水平;联合组BDNF mRNA的表达水平较孕酮组或训练组更高(P<0.01)。结论:早期应用孕酮和减重步行训练均能促进SCI大鼠的运动功能恢复,其机制之一可能是上调局部BDNF mRNA的表达,促进神经再生;两者联合应用的效果比单一应用更好。Objective：To investigate the effects of progesterone and body weight support treadmill training（BWSTT） on locomotion,spinal morphology and expression of BDNF mRNA in spinal cord injured（SCI） rats.Methods： One hundred and twenty male Sprague-Dawley rats were randomly divided into groups sham-operation,control,progesterone,BWSTT and the combined.The SCI models were established according to the modified Allen＇s contusion method.Injections of 4 mg/kg progesterone were given at 30 min,6,24,48 and 72 h post-lesion by intraperitoneal.BWSTT was initiated one week after SCI.At different time points after SCI,the functional changes were evaluated by BBB method,the morphological changes by HE staining and the expressions of BDNF mRNA through RT-PCR methods.Results： The functional recovery of rats＇ hind limb in the progesterone and BWSTT groups was quicker than that in the control group.The morphology studies showed that neural regeneration occurred later.The RT-PCR results showed the expression of BDNF mRNA was consistently low in sham operation group,while it was increased within three days in the control group.In the progesterone group,it was high in the first week and reached the peak at day 3.In addition,the expression of BDNF mRNA was significantly increased from the 14th day and remained at a high level even in one week after the termination of BWSTT in the BWSTT group.It was even higher in combined group than that in the progesterone or BWSTT group（P0.01）.Conclusion： Both progesterone and BWSTT are capable to facilitate the recovery of motor function after SCI.One possible reason may be that the progesterone and BWSTT enhance BDNF experssion in the damaged tissues.Meanwhile,the performance with the combination of progesterone and BWSTT is better than the either single one.

关 键 词：脊髓损伤后 孕酮 减重步行训练 脑源性神经营养因子 逆转录聚合酶链反应 模型组 大鼠 训练组 神经再生 早期应用 

分 类 号：R741[医药卫生—神经病学与精神病学] R651[医药卫生—临床医学]