早期康复训练对脑梗死患者SIRT1/PGC-1a通路介导氧化应激及细胞凋亡的影响  

Effect of early rehabilitation training on oxidative stress and apoptosis mediated by SIRT1/PGC-1α pathway in patients with cerebral infarction

作　　者：谢永权 郭书玲 谢桂芬 XIE Yongquan;GUO Shuling;XIE Guifen(Department of Neurology,Zunhua People's Hospital,Tangshan,Hebei,China,064200;Department of Gynecology,Zunhua People's Hospital,Tangshan,Hebei,China,064200)

机构地区：[1]遵化市人民医院神经内科,河北唐山064200 [2]遵化市妇幼保健院妇科学,河北唐山064200

出　　处：《分子诊断与治疗杂志》2023年第1期115-119,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生厅科研项目(20181416)。

摘　　要：目的 研究早期康复训练对脑梗死患者沉默信息调节因子1(SIRT1)/过氧化物酶体增殖物激活受体γ共激活因子-1α(PGC-1a)通路介导氧化应激及细胞凋亡的影响。方法 选择2020年1月至2021年6月期间遵化市人民医院接受保守治疗的急性脑梗死患者,分析病史资料并根据康复训练起始时间分为进行早期康复训练的研究组、进行常规康复训练的对照组。干预前及干预后4周,进行美国国立卫生研究院卒中量表(NIHSS)和改良Barthel指数(MBI)评价,检测血清NSE、S100B、MDA、SOD、Bcl-2、Caspase-3含量及外周血SIRT1、PGC-1a的mRNA表达水平,随访起病后1年内脑梗死累积复发情况。结果 两组干预后的NIHSS评分、血清NSE、S100B、MDA、Caspase-3含量降低,MBI评分、血清SOD及Bcl-2含量、外周血SIRT1、PGC-1a的mRNA表达水平增加,以研究组更显著,两组间干预后比较的差异有统计学意义(t=5.927、5.005、14.834、10.068、8.696、14.075、5.843、10.570、9.607、7.223,P<0.05)。结论 早期康复训练促进急性脑梗死患者神经功能恢复的作用与促进SIRT1/PGC-1a通路激活、抑制氧化应激及细胞凋亡有关。Objective To study the effect of early rehabilitation training on oxidative stress and apoptosis mediated by SIRT1/PGC-1α pathway in patients with cerebral infarction. Methods The patients with acute cerebral infarction who received conservative treatment in Zunhua People’s Hospital from January2020 to June 2021 were selected. The medical history was reviewed and the patients were divided into two groups according to the starting time of rehabilitation training:the study group for early rehabilitation training and the control group for routine rehabilitation training. Before and 4 weeks after intervention,National Institute of Health stroke scale(NIHSS)and modified Barthel index(MBI)were evaluated,the contents of NSE,S100B,MDA,SOD,Bcl-2,caspase-3 in serum and the mRNA expression of SIRT1 and PGC-1a in peripheral blood were detected. The cumulative recurrence of cerebral infarction within 1 year after onset was followed up. Results After intervention,NIHSS score,serum NSE,S100B,MDA,caspase-3 content decreased,MBI score,serum SOD and Bcl-2 content,peripheral blood SIRT1,PGC-1a mRNA expression level significantly increased in the two groups,especially in the study group,and the difference between the two groups after intervention was statistically significant(t=5.927,5.005,14.834,10.068,8.696,14.075,5.843,10.570,9.607,7.223,P<0.05). Conclusion The role of early rehabilitation training in promoting the recovery of neurological function in patients with acute cerebral infarction is related to the promotion of SIRT1/PGC-1a pathway activation,inhibition of oxidative stress and apoptosis.

关 键 词：急性脑梗死 早期康复训练 氧化应激 细胞凋亡 SIRT1/PGC-1a通路 

分 类 号：R743.33[医药卫生—神经病学与精神病学]