植入式皮质电刺激对脑梗死后尼氏体和生长相关蛋白-43的影响

Implanted cortical electrical stimulation and the expressions of Nissl bodies and growth-associated protein 43 in the brain after ischemic injury

目的观察植入式皮质电刺激对脑梗死后尼氏体和生长相关蛋白43（GAP-43）表达的影响，探讨植入式皮质电刺激治疗脑梗死的机制。方法制作雄性SD大鼠大脑中动脉梗死（MCAO）模型，选取磁共振成像（MRI）示皮质梗死的大鼠23只，按随机数字表法分为皮质电刺激组（13只）和无电刺激组（共10只）。皮质电刺激组植入电刺激器后连续刺激14d，无电刺激组植入电刺激器但不进行电刺激。6周后，取皮质电刺激组梗死灶周边电刺激部位（无电刺激组取相同部位）进行尼氏染色和GAP-43的免疫组织化学染色，用Image-Pro Plus6．0版图像系统进行分析，测量尼氏体占图片总面积的比例，以及GAP-43的阳性表达面积占图片总面积的比例。结果在梗死灶周围，皮质电刺激组尼氏体着色较深，其尼氏体所占比例为（9．7±2．3）％，高于无电刺激组的（5．9±2．0）％，差异有统计学意义（P〈0．01）；皮质电刺激组GAP-43的阳性表达区域着色较深，其GAP-43的阳性区域比例位（19．3±2．9）％，明显高于无电刺激组的（15．8±3．4）％，差异有统计学意义（P〈0．05）。结论植入式皮质电刺激可增加脑梗死灶周边尼氏体和GAP-43的表达，提示植入式皮质电刺激可通过促进脑梗死灶周围神经元内尼氏体功能的恢复，从而促进轴突生长，重建神经网络，并改善神经缺损功能。

Objective To investigate the effect of implanted cortical electrical stimulation （CES） on the expression of Nissl bodies and growth-associated protein 43 （GAP-d3） in the brain after ischemic injury, and its mechanism. Methods Models of middle cerebral artery occlusion （MCAO） were established in 23 male Sprague-Dawley rats. They were randomly divided into a CES group （CES, n = 13） and a no stimulation group （NS, n = 10） and electrical Stimulators were implanted in both groups. CES was applied for 14 d in the CES group but not in the NS group. The expression of Nissl bodies and GAP-43 around the infarct were quantified using version 6.0 of the Image- Pro Plus system. Results In the CES group the Nissl bodies had a deep color, and their percentage of area was higher than that in the NS group. The GAP-43 positive expression area also had a relatively deep color, and the average percentage of positive expression area was also higher than that in the NS group. Conclusions CES can enhance the expression of Nissl bodies and GAP-43 after cerebral infarction. This suggests that CES can promote axon growth and the formation of new neural circuits.