重复经颅磁刺激通过抑制线粒体凋亡途径对缺血再灌注大鼠脑组织损伤的干预作用  

Intervention effects of repetitive transcranial magnetic stimulation on brain tissue damage in rats with ischemia reperfusion via inhibiting mitochondrial apoptosis approach

作　　者：方增焜 黄永[1] 李昌柳[2] 黄东挺[3] 江文宇[4] 董奎[2] FANG Zeng-kun;HUANG Yong;LI Chang-liu;HUANG Dong-ting;JIANG Wen-yu;DONG Kui(Department of Rehabilitation Medicine,Guangxi International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530000,China;Department of Physiotherapy,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China;Department of Science and Education,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China;Department of Neurological Rehabilitation,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China)

机构地区：[1]广西中医药大学附属国际壮医医院康复医学科,南宁市530000 [2]广西壮族自治区江滨医院物理治疗科,南宁市530000 [3]广西壮族自治区江滨医院科教部,南宁市530000 [4]广西壮族自治区江滨医院神经康复科,南宁市530000

出　　处：《广西医学》2022年第11期1255-1259,共5页Guangxi Medical Journal

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2018092);广西中医药重点学科建设项目(GZXK-Z-20-31);广西科技计划(桂科AD20238075)。

摘　　要：目的探讨重复经颅磁刺激(rTMS)对缺血再灌注大鼠的干预作用,并基于线粒体凋亡途径分析其作用机制。方法将18只大鼠随机分为假手术组、缺血再灌注组、缺血再灌注+rTMS组,每组6只。除假手术组外其他组以大脑中动脉闭塞法建立缺血再灌注模型,手术结束后2 h即开始采用rTMS干预缺血再灌注+rTMS组大鼠。分别于术后第1、3、7天,采用改良神经功能缺损评分(mNSS)评估各组大鼠的运动功能。术后第7天取各组大鼠脑组织,观察缺血脑组织的病理学改变和缺血周围皮层组织的线粒体超微结构,检测缺血周围皮层组织的细胞凋亡率及缺血脑组织的Caspase-9、细胞色素C(CytC)、B细胞淋巴瘤2相关X蛋白(Bax)的蛋白表达量。结果(1)术后各时间点其余两组的mNSS均高于假手术组,而术后第7天缺血再灌注+rTMS组mNSS低于缺血再灌注组(均P<0.05);3组的mNSS均有随时间下降的趋势(P<0.05)。(2)缺血再灌注组大鼠出现较大的脑缺血梗死面积,以及组织疏松、细胞稀疏、肿胀等异常表现;而缺血再灌注+rTMS组大鼠的梗死区域较缺血再灌注组明显缩小,上述异常表现减轻。(3)缺血再灌注组大鼠脑缺血周围皮层组织中的细胞凋亡率升高,大部分线粒体结构破坏明显,数目显著减少,呈现线粒体空泡化趋势,而缺血再灌注+rTMS组的细胞凋亡率降低,上述异常表现均明显减轻。(4)缺血再灌注组缺血脑组织的Caspase-9、CytC、Bax的蛋白表达量均高于假手术组(均P<0.05);缺血再灌注+rTMS组缺血脑组织的CytC、Bax的蛋白表达量均低于缺血再灌注组(均P<0.05)。结论rTMS或通过抑制线粒体凋亡途径减轻缺血再灌注大鼠的脑组织损伤。Objective To explore the intervention effects of repetitive transcranial magnetic stimulation(rTMS)on rats with ischemia reperfusion,and to analyze its mechanism of action based on the approach to mitochondrial apoptosis.Methods A total of 18 rats were randomly assigned to sham operation group,ischemia reperfusion group,or ischemia reperfusion plus rTMS group,with six rats in each group.Except for the sham operation group,the ischemia reperfusion model was established by middle cerebral artery occlusion in the remaining groups.Two hours after the end of operation,rTMS started to intervene rats in the ischemia reperfusion plus rTMS group.The modified Neurological Severity Score(mNSS)was employed to evaluate the motor function of rats in various groups on the first,third and seventh day after operation,respectively.On the seventh day after operation,the brain tissues of rats in various groups were obtained;the pathological changes of ischemic brain tissues and the mitochondrial ultra structure in peri-ischemic cortex tissues were observed;the apoptosis rate in peri-ischemic cortex tissues as well as the protein expression of Caspase-9,cytochrome C(CytC),and B-cell lymphoma-2-associated X protein(Bax)in ischemic brain tissues was detected.Results(1)Compared with the sham operation group,the remaining two groups exhibited higher mNSSs at various time points after operation,whereas mNSS on the seventh day after operation was lower in the ischemia reperfusion plus rTMS group than in the ischemia reperfusion group(all P<0.05);mNSS in the three groups depicted a decline tendency over time(P<0.05).(2)Rats in the ischemia reperfusion group appeared a relatively large area of ischemic cerebral infarction,as well as the abnormal manifestations with respect to tissue porosity,sparse cells,and tumidness;whereas rats in the ischemia reperfusion plus rTMS group obtained a significantly narrow area of infarction as compared with the ischemia reperfusion group,and the abnormal manifestations as above were alleviated.(3)Rats in the

关 键 词：缺血再灌注 重复经颅磁刺激 线粒体凋亡 促凋亡蛋白 大鼠 

分 类 号：R965[医药卫生—药理学]