cAMP/PKA-pCREB信号通路在早期康复训练改善脑梗死患者神经功能中的作用  

Role of cAMP/PKA-pCREB signaling pathway in early rehabilitation training to improve neurological function in patients with cerebral infarction

作　　者：郭书玲 谢永权 谢桂芬 GUO Shuling;XIE Yongquan;XIE Guifen(Department of Neurology,Zunhua People's Hospital,Tangshan,Hebei,China,064200;Department of Gynecology of Zunhua Maternal and Child Health 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2期226-230,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 探讨cAMP/PKA-pCREB信号通路在早期康复训练改善脑梗死患者神经功能中的作用。方法 收集2020年3月至2022年3月间在遵化市人民医院接受治疗的脑梗死康复期患者228例作为研究对象,参照随机数表法将所有入组患者分为对照组、观察组各114例,对照组患者接受康复期常规药物干预,观察组患者在对照组药物使用基础上加入早期康复训练干预,持续干预8周后评估结果。对比两组患者的干预后简易Fugl-Meyer评分法(FMA)、改良Barthel指数(MBI),血清神经功能相关因子[神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)]水平,外周血单个核细胞(PBMC)c AMP/PKA-pCREB信号通路相关分子(c AMP、PKA、pCREB)表达水平的差异。结果 干预8周后,观察组患者的FMA上肢评分、FMA下肢评分、MBI评分值高于对照组患者,差异有统计学意义(t=17.710、10.134、7.188,P<0.05);血清NSE水平低于对照组患者,BDNF、NGF水平高于对照组患者,差异有统计学意义(t=8.588、7.229、5.535,P<0.05);PBMC的cAMP、PKA、pCREB mRNA表达量高于对照组患者,差异均有统计学意义(t=4.996、1.868、3.320,P<0.05)。结论 早期康复训练可能通过激活cAMP/PKA-pCREB信号通路优化肢体功能、减轻脑损伤,是一种较为理想及必要的干预手段。Objective To investigate the role of cAMP/PKA-pCREB signaling pathway in improving neurological function of patients with cerebral infarction by early rehabilitation training. Methods A total of 228 patients with cerebral infarction who received treatment in Zunhua People’s Hospital during the rehabilitation period from March 2020 to March 2022 were collected as the research objects,all patients were divided into the control group and the observation group with 114 cases in each group according to the random number table method. Patients in the control group received routine drug intervention during the rehabilitation period,and patients in the observation group received early rehabilitation training intervention on the basis of drug use in the control group,and the results were evaluated after 8 weeks of continuous intervention. After the intervention,the simple Fugl-Meyer score(FMA),modified Barthel index(MBI),serum neurological function-related factors[neuron-specific enolase(NSE),brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)]were compared between the two groups. The differences in the expression levels of cAMP/PKA-pCREB signaling related molecules(cAMP,PKA,pCREB)in peripheral blood mononuclear cells(PBMC)were compared between the two groups. Results After 8 weeks of intervention,the FMA upper limb score,FMA lower limb score and MBI score of patients in the observation group were higher than those in the control group(t=17.710,10.134,7.188,P<0.05). The levels of serum NSE were lower than that in the control group,while the levels of BDNF and NGF were higher than those in the control group(t=8.588,7.229,5.535,P<0.05). The cAMP,PKA,and p CREB m RNA expressions in PBMC were higher than those in the control group,and the differences were statistically significant(t=4.996,1.868,3.320,P<0.05). Conclusion Early rehabilitation training may optimize limb function and reduce brain injury by activating cAMP/PKA-pCREB signaling pathway,which is an ideal and necessary intervention.

关 键 词：脑梗死 早期康复训练 神经功能 cAMP/PKA-pCREB信号通路 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]