重复经颅磁刺激治疗脑出血家兔的实验研究  

An experimental study of the effects of repetitive transcranial magnetic stimulation on cerebral hemorrhage in rabbits

作　　者：王涛[1] 郭铁成[2] 朱晓临 张扬[1] 张允健[1] 孙圣刚[1] 梅元武[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经科,武汉430022 [2]华中科技大学同济医学院附属同济医院康复医学科 [3]河南省洛阳市东方医院神经科

出　　处：《中华物理医学与康复杂志》2003年第7期390-393,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　探讨重复经颅磁刺激 (rTMS)对脑出血家兔的治疗作用及其相关机制。方法　家兔 3 6只 ,随机分为A、B、C组。A组 (治疗组 )和B组 (模型组 )采用家兔自体血注射制作脑出血模型 ,C组 (对照组 )注射生理盐水。A组家兔于造模后 12h开始实施rTMS ,每日 3次 ;B组和C组不进行rTMS。各组家兔分别于模型制作后 12h、2 4h、48h、72h、1周、2周处死。采用TUNEL法和免疫组化技术 ,检测出血灶周围脑组织中细胞凋亡及bcl 2、TNF α和IL 6的表达。结果　 3组均未见自发性出血。C组未见凋亡细胞及bcl 2阳性表达 ;A组和B组均有凋亡细胞和bcl 2表达水平增高 ,2组相比 ,A组的凋亡细胞较少 ,bcl 2表达水平更高(P <0 .0 5 )。C组无TNF α和IL 6阳性细胞 ;A组和B组均有TNF α和IL 6表达 ,2组相比 ,A组的TNF α表达水平较低 ,IL 6表达较高 (P均 <0 .0 5 )。结论　rTMS刺激可通过调控炎症因子表达、减轻炎性损伤以及上调bcl 2的表达、减少细胞凋亡 ,在脑出血中发挥治疗作用。Objective To observe the possible therapeutic effect of repetitive transcranial magnetic stimulation(rTMS) on cerebral hemorrhage in rabbits and explore the underlying mechanism. Methods Thirty-six rabbits were divided randomly into 3 groups, group A (receiving rTMS) and group B (no rTMS) were experimental groups, and group C was control group. The cerebral hemorrhage model was made by injection of self-body blood, and the control group was made by injection of saline. The rabbits in group A were treated with rTMS 3 times a day and those in the groups B and C without rTMS. Rabbits in all the 3 groups were sacrificed separately after 12, 24, 48, 72 hours and 1 and 2 weeks after the establishment of the model. TUNEL and immunohistochemistry methods were used to detect the apoptosis and the expressions of TNF-α, bcl-2 and IL- 6 in the perihematomal brain tissues. Results No spontaneous intracerebral hemorrhage was observed in all of the 3 groups. Neither positive apoptotic cell and bcl-2 expression nor expressions of TNF-α and IL- 6 was observed in group C. The apoptotic cells were found in both groups A and B, with less of the cells in group A than those in group B(P<0.05). The increased expressions of bcl-2, TNF-α and IL- 6 were detected in both groups A and B. Compared to group B, the levels of bcl-2 and IL- 6 were significantly higher in group A (P<0.05), and in contrast, the expressions of TNF-α was reduced to a significant extent in group A after rTMS (P<0.05). Conclusion rTMS could be beneficial for treating cerebral hemorrhage by regulating the expressions of the inflammatory cytokines such as TNF-α and IL- 6, diminishing the inflammatory lesions, and reducing the apoptosis course by up-regulating the expression of bcl-2.

关 键 词：脑出血 重复经颅磁刺激 BCL-2基因 细胞凋亡 肿瘤坏死因子 白细胞介素-6 动物实验 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R454.1[医药卫生—临床医学]