重复经颅磁刺激对急性脑梗死患者血清白介素-6水平及神经功能康复的影响  

Effects of Repetitive Transcranial Magnetic Stimulation on Serum Levels of Interleukin-6 and Neurologic Function Rehabilitation in Acute Cerebral Infarction

作　　者：李辉萍[1] 邓景贵[1] 宋涛[1] 周文胜[1] 杨剑文[1] 徐伟[2] 宋治[3] 

机构地区：[1]湖南省马王堆医院神经内科,湖南省长沙市410016 [2]长沙市中心医院神经内科 [3]中南大学湘雅三医院神经内科

出　　处：《中国全科医学》2010年第33期3709-3711,共3页Chinese General Practice

摘　　要：目的观察重复经颅磁刺激(rTMS)对急性脑梗死患者血清白介素-6(IL-6)水平及神经功能康复的影响,探讨rTMS的神经保护机制。方法选择发病3 d内的脑梗死患者40例,随机分为rTMS组和假rTMS组,两组均予常规药物、康复治疗。rTMS组给予rTMS真刺激;假rTMS组给予rTMS假刺激。观察rTMS治疗前及治疗后3、7、10 d两组患者的美国国立卫生院卒中量表(NIH stroke scale,NIHSS)评分、Barthel指数(Barthel index,BI)评分及血清IL-6水平。结果采用重复测量方差分析,结果显示rTMS处理因素对各观察指标均有显著性影响〔对于NIHSS、BI评分及IL-6水平分别是F(1,38)=147.49,P<0.01;F(1,38)=96.58,P<0.01;F(1,38)=907.51,P<0.01〕;rTMS处理因素与时间因素存在交互作用〔对于NIHSS、BI评分及IL-6水平分别是F(3,114)=569.92,P<0.01;F(1.49,56.62)=416.22,P<0.01;F(1,38)=41 183.37,P<0.01〕。采用直线相关分析,血清IL-6水平与NIHSS评分呈正相关(r=0.753,P<0.01);与BI评分呈负相关(r=-0.729,P<0.01)。结论 rTMS可能通过减轻脑梗死后IL-6介导的炎性反应,促进神经功能康复。Objective To observe the effectsof repetitive transcranial magnetic stimulation（rTMS） on serumlevelsof interleukin-6（IL-6） and neurologic function rehabilitation in patients with acute cerebral infarction（ACI）,and investigate the neuroprotection of rTMS in ACI.Methods Forty patients experiencing ACI that occurred within the first 3 days were randomly divided into two groups as real rTMS group and sham rTMS group.Both groups were given routine drugs and rehabilitation treatment.Meanwhile,real rTMS group received rTMS,but sham rTMS group received sham rTMS.NIH stroke scale（NIHSS）,Barthel Index（BI） scores and serum levels of IL-6 were measured before,3 days,7 days and 10 days after rTMS treatment.Results Repeated measures ANOVA revealed a treatment and time interaction 〔F（3,114） = 569.92,P 0.01 for NIHSS;F（1.49,56.62） = 416.22,P 0.01 for BI;F（1,38） = 41 183.37,P 0.01 for IL-6〕,and rTMS influenced observation index significantly 〔F（1,38） = 147.49,P 0.01 for NIHSS;F（1,38） = 96.58,P 0.01 for BI; F（1,38） = 907.51,P 0.01 for IL-6〕.Linear correlation analysis revealed serum levels of IL-6 had a positive correlation with the scores of NIHSS（r = 0.753,P 0.01） and a negative correlation with the scores of BI（r =-0.729,P 0.01）.Conclusion rTMS has an anti-inflammatory effect and can promote neurologic function rehabilitation in ACI.

关 键 词：重复经颅磁刺激 脑梗死 白细胞介素-6 康复 

分 类 号：R743.33[医药卫生—神经病学与精神病学]