胞二磷胆碱结合康复训练对脑缺血大鼠神经可塑性的影响  

The effects of citicoline combined with rehabilitative training on neural plasticity after focal cerebral ischemia

作　　者：毕然然[1] 崔宝娟[1] 王珊珊[2] 王道清[1] 王晓红[1] 孙强三[1] 

机构地区：[1]山东大学第二医院康复医学科,济南250033 [2]山东省交通医院康复医学科

出　　处：《中华物理医学与康复杂志》2010年第7期492-497,共6页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：山东省中医药管理局基金项目（2005046）

摘　　要：目的观察胞二磷胆碱结合康复训练对脑缺血大鼠运动功能及钙结合蛋白（S100）、β微管蛋白（β-tubulin）的影响。方法120只成年雄性Sprague-Dawley（sD）大鼠采用Longa线栓法制作大鼠左侧大脑中动脉闭塞（MCAO）模型，选出造模成功后符合标准的96只大鼠分为对照组、药物组、康复组、药物联合康复组，每组24只。造模成功后3d，对照组不做任何干预，药物组开始给予胞二磷胆碱（每天500mg／kg体重），康复组开始进行滚笼、平衡木、转棒、网屏等训练，药物联合康复组既给予胞二磷胆碱，又给予康复训练。各组分别在造模后第7，14，21天时进行行为学评估综合评分；各组取脑组织行免疫组化法观察缺血周围皮质S100、β-tubulin的表达。结果①各组大鼠随时间推移行为学评分均逐渐减少，药物组造模后第7，14，2l天以及康复组、药物联合康复组造模后第7天行为学评分分别与同一时间点对照组比较，差异无统计学意义（P〉0．05）；康复组、药物联合康复组造模后第14，21天行为学评分明显优于同一时间点对照组，差异有统计学意义（P〈0．05），且药物联合康复组降低更明显（P〈0．01）。②造模后第7天药物组、康复组S100、β-tubulin的表达水平与同一时间点对照组比较，增加不明显（P〉0．05）；造模后第7天药物联合康复组S100、β-tubulin的表达水平较同一时间点药物组、康复组增加明显，差异有统计学意义（P〈0．01）；造模后第14，21天时药物组、康复组、药物联合康复组S100、β-tubulin的表达水平较对照组增加（P〈0．05），且药物联合康复组较药物组、康复组增加更显著（P〈0．01）。结论胞二磷胆碱结合合理有序的康复训练能明显改善脑缺血大鼠运动功能，其机制可能与缺血周围皮质S100、βtubulin表达上调有关。Objective To investigate the effects function after focal cerebral ischemia. Methods One months old） were subjected to left middle cerebral artery randomly divided into four groups of 24 ： a control group, of citicoline combined with rehabilitative training on motor hundred and twenty male adult Sprague-Dawley rats （3 occlusion （MCAO） by suturing. Ninety-six of them were a drug group, a rehabilitative training group, and a drug combined with rehabilitative training group. The rats in the control group did not receive any treatment. Three days after reperfusion, those in the drug group received 500 mg/kg of citicoline daily; those in the rehabilitative training group received motor training including balancing, grasping, rotating and walking exercises; those in the combined group received both citicoline and the motor training program. Behavioral tests were administered at the 7th, 14th and 21st days after MCAO. At the same time points, immunohistochemistry was used to detect calcium-binding protein S100 and β-tubulin expression in the peri-ischemia region of the cortex. Results （1）As compared with the control group, the drug group at the 7th, 14th and 21st day after MCAO aud the other two groups at the 7th day after MCAO showed no significant difference in average behavior scores. But at the 14th and 21st day the rehabilitative training group as well as the drug combined with rehabilitative training group had average behavior scores significantly superior to those of the control group, especially in the drug combined with rehabilitative training group. （2）As compared with the control group, the expression of S100 and β-tubulin in the drug and rehabilitative training groups at the 7th day after MCAO showed no significant difference. In the drug combined with rehabilitative training group the average score was significantly higher than in the other groups at the 7th day after MCAO. All the other groups had average scores significantly higher than that of the controls at the 14th and 21st day aft

关 键 词：脑缺血 胞二磷胆碱 康复训练 钙结合蛋白 β微管蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]