功能性电刺激对急性脑梗死大鼠运动功能及室管膜下区的溴氧尿嘧啶核苷＋／神经胶质纤维酸性蛋白＋细胞表达的影响  

Effects of functional electrical stimulation on motor function and the expression of bromodeoxyuridine ＋ and glial fibrillary acid protein ＋ cells in the subventricular zone after cerebral infarction

作　　者：刘慧华[1] 燕铁斌[1] 李胜活[2] 赵俊红[1] 郑修元[1] 何晓阔[1] 

机构地区：[1]中山大学孙逸仙纪念医院康复医学科,广州510120 [2]广州医学院第二附属医院康复医学科

出　　处：《中华物理医学与康复杂志》2012年第3期161-165,共5页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察不同时间点功能性电刺激（FES）对急性脑梗死大鼠神经功能和室管膜下区（SVZ）溴氧尿嘧啶核苷（BrdU）＋／神经胶质纤维酸性蛋白（GFAP）＋细胞表达的影响，探讨FES治疗急性脑梗死的可能机制。方法采用大脑中动脉阻塞（MCAO）法制作急性脑梗死大鼠模型，制模成功72只。按随机数字表法分为对照组、安慰组和FES组，每组各24只。3组再按治疗时间分为1、3、7和14d四个亚组，每个亚组6只。对照组没有进行任何治疗；安慰组大鼠瘫痪侧前肢仅贴附表面电极，连接FES治疗仪，关闭机器电源；FES组制模成功后第3天开始以表面电极刺激瘫痪侧前肢，治疗强度以引起瘫痪侧出现伸腕伸指动作为准（约4～5mA），每次治疗15min，1次／日。治疗前及治疗各时间点（1、3、7和14d）采用改良神经功能损害评分法（mNSS）对大鼠神经功能变化评分；使用免疫组织荧光化学法检测缺血侧SVZ表达5-BrdU以及GFAP细胞数目的改变。结果治疗7d和14d后，FES组大鼠mNSS评分较其它2组明显改善（P〈0．05），其中运动功能评分改善尤为明显（P〈0．05）。治疗第3天FES组BrdU阳性细胞、BrdU＋／GFAP＋双标阳性细胞数及阳性率与其它2组比较，差异均有统计学意义（P〈0．05）；治疗第7天各组BrdU阳性细胞、双标阳性细胞数均达到峰值，FES组BrdU阳性细胞、双标阳性率与其它2组比较，差异有统计学意义（P〈0．05）；治疗第14天FES组BrdU阳性细胞、双标阳性率与其它2组比较，差异有统计学意义（P〈0．05）。结论FES治疗能明显改善急性脑梗死大鼠神经功能，促进SVZ神经干细胞的增殖和分化。Objective To investigate the effects of functional electrical stimulation （FES） on motor function and the expression of bromodeoxyuridine （Brdu） ＋ and glial fibrillary acid protein （GFAP） ＋ in the subventricular zone （SVZ） of rats with acute cerebral infarction, and to explore it＇s mechanism. Methods A rat model of cere- bral infarction was established using Longa＇s technique for middle cerebral artery occlusion （MCAO） with an intraluminal filament. The rats were randomly divided into a FES group, a placebo stimulation group and a control group. In each group, rats were randomly allocated into 1 d, 3 d, 7 d and 14 d subgroups （6 rats/subgroup）. Superficial electrodes were pasted on the paralyzed forelimbs of rats in the FES group for connecting with the FES instrument, and FES treatment was carried out with a current of 4-5 mA for 15 min on the third day after the MCAO operation to produce extension of the wrist and the digits of the paralyzed forelimb. The rats in the placebo stimulation group were pasted with electrodes, but no FES was administered and they received no other treatment. Neurological deficits were evaluated using the modified neurological severity score （mNSS） before treatment and on the 1st, 3rd, 7th, and 14th day after treatment. BrdU and GFAP positive cells in the SVZ were detected by immunofluorescence techniques. Results After 7 or 14 days the motor function of rats in the FES group had improved significantly compared with the placebo stimulation and control groups. Compared with the other two groups, the expression levels of BrdU ＋ and GFAP＋ cells in the ischemic SVZ in the FES group were significantly higher at the 3rd, 7th and 14th day.Conclusion FES can improve motor function after acute cerebral infarction and also promote the proliferation and differentiation of neural stem cells in the SVZ.

关 键 词：功能性电刺激 脑梗死 神经可塑性 室管膜下区 

分 类 号：R743.3[医药卫生—神经病学与精神病学]