不同时间点介入运动再学习对大脑中动脉闭塞大鼠神经功能恢复的影响  

The effect of a motor relearning programme on the recovery of neurological function after middle cerebralartery occlusion

作　　者：孙敏[1] 王道清[2] 王晓红[2] 崔宝娟[2] 曾凡硕[2] 黄来刚 刘本玲[1] 孙强三[2] 

机构地区：[1]山东大学,济南250012 [2]山东大学第二医院

出　　处：《中华物理医学与康复杂志》2014年第4期241-245,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：山东省自然科学基金项目（2009ZRA01001）

摘　　要：目的探讨不同时间点介入运动再学习对大脑中动脉闭塞（MCAO）大鼠神经功能恢复的影响。方法选取雄性SD大鼠90只，按照随机数字表法将其分为运动再学习组（54只）、对照组（18只）和假手术组（18只），依据运动再学习的介入时间不同，将运动再学习组细分为造模后3d亚组（18只）、造模后7d亚组（18只）、造模后14d亚组（18只）。采用大脑中动脉闭塞法对所有大鼠进行造模，1．5h后，将运动再学习组和对照组大鼠所用造模线栓拉出1cm，造成再灌注损伤，假手术组不予以特殊处理。造模后3d、7d及14d，分别给予运动再学习各亚组大鼠运动再学习训练。造模后7d、14d及21d，采用神经行为学评分评定大鼠的神经功能恢复情况，采用荧光定量PCR技术检测大鼠可塑性相关基因15（CPGl5）、核转录因子B（NF—kB）的表达水平。结果造模后3d亚组神经功能评分、CPGl5含量及NF—kB水平均优于造模后7d亚组和造模后14d亚组（P〈0．05），造模后7d亚组上述指标均优于造模后14d亚组（P〈0．05）。与对照组同时间点比较，造模后3d亚组所有时间点的神经功能评分均较低（P〈0．05），造模后7d亚组在造模7d时[（10．477±0．163）分]的评分较低（P〉0．05），造模后14d亚组在造模7d[（10．503±0．245）分]及14d时[（8．673±0．261）分]的神经功能评分亦较低（P〉0．05）。造模后3d亚组所有时间点的CPGl5水平均高于对照组（P〈0．05），造模后7d亚组在造模7d时的CPG水平较高（P〉0．05），造模后14d亚组所有时间点的CPGl5水平亦较高（P〉0．05）。造模后3d亚组不同时间点的NF—kB水平均较对照组低（P〈0．05），造模后7d亚组在造模7d时的NF—xB水平较低（P〉0．05），造模后14d亚组所有时间点的NF—kB水平亦较低（P〉0．05）。结论运动再学习能显著改善MCAO大鼠的神经功能，MCAO后3d介入Objective To investigate the effect of a motor relearning programme （MRP） on the recovery of neurological function after ischemic brain impairment eaueed by middle cerebral artery occlusion （MCAO）. Methods Ninety adult, healthy, male Sprague-Dawley rats were randomly divided into a group which received a motor relearning programme （54 rats） , a control group （18 rats） and a sham operation group （18 rats）. The group trained with the motor relearning programme was randomly subdivided into 3 subgroups of 18 according to when the programme began ： 3, 7 or 14 days after occlusion. The middle cerebral artery was occluded with thread for 90 min. The rats in the sham operation group were not occluded. After ninety minutes, the thread was released to induce reperfusion injury. Bederson＇s method was used to assess the recovery of neural function after 7, 14 and 21 days. The mRNA levels of candidate plasticity-related gene 15 （CPG-15） and nuclear factorKB （NF-KB） were determined by RT-PCR, Results Neurological function scores and the CPG15 and NF-KB levels had all improved significantly more in the 3 days after occlusion subgroup than in the 7 days and 14 days groups. The 3 indexes were similarly sig- nificantly better in the 7 days subgroup than in the 14 days group. The average neurological function score of the con- trol group was best at all time points. The average CPG15 level of the 3 days subgroup was significantly higher thanthat of the control group at all time points. The CPG15 level differences in the 7 days and 14 days subgroups with re- spect to the control group were not significant. Compared with the control group, the average NF-KB level in the 3 days subgroup was significantly lower. The differences in the other groups were not significant. Conclusions A motor relearning programme can improve neurological function after MCAO-induced ischemic cerebral impairment. It should be begun no more than 3 days after MCAO.

关 键 词：运动再学习 大脑中动脉缺血 可塑性相关基因15 核转录因子B 

分 类 号：R743.3[医药卫生—神经病学与精神病学]