强制性运动联合高压氧对脑缺血大鼠神经功能及GFAP表达的影响

Effects of Constraint-Induced Movement Therapy and Hyperbaric Oxygen Therapy on Neural Function and GFAP Expression after Middle Cerebral Artery Occlusion in Rats

目的:探讨强制性运动联合高压氧对局灶性脑缺血大鼠的不同时间点神经功能评分及灶周胶质纤维酸性蛋白(GFAP)表达的影响。方法:200只SD雄性大鼠采用插线法制作大脑中动脉闭塞(MCAO)局灶性脑缺血模型,随机分为假手术组、模型组、强制性运动组(CIMT组),高压氧组和强制性运动联合高压氧组各40只,每组随机分为7 d、14 d、21 d、28 d和35 d 5个亚组,每个亚组各8只大鼠。造模24 h后模型组和正常组动物自然饲养,不作特殊处理,其他组行相应治疗,分别于相应天数进行神经功能缺损评分,随后取脑采用免疫组织化学方法观察每个时间点脑梗死灶周围GFAP的表达。结果:假手术组神经功能缺损评分为0,造模后各时间点强制性运动联合高压氧组大鼠神经功能缺损评分明显低于模型组、CIM组和高压氧组(P<0.01),与模型组比较,CIMT组、高压氧组在28 d和35 d神经功能缺损评分减低(P<0.05),CIM组在造模后35 d与高压氧组神经功能缺损评分比较无统计学差异(P﹥0.05)。各治疗组在各时间段GFAP表达均低于模型组(P<0.05),强制性运动联合高压氧组与CIM组和高压氧组比较在造模后7 d、14 d、21 d和28 d缺血区周围GFAP表达明显减少(P<0.05),在35 d缺血区周围GFAP表达减少但统计无显著性差异(P﹥0.05)。结论:强制性运动联合高压氧可抑制脑梗死灶周围GFAP的表达,改善星形胶质细胞(astrocyte,AST)活性,提高中枢神经系统的自我修复能力。

Objective ：To investigate the effect of constraint- induced movement therapy （CIMT） and hyperbaric oxy- gen therapy on the neural function and the expression of glial fibrillary acidic protein （GFAP） ＇after middle cerebral artery occlusion in rats. Methods ：200 healthy female SD rats were randomly divided into 5 groups：sham operation group, model group, constraint -induced movement therapy group, hyperbaric oxygen therapy group, and constraint -induced movement therapy with hyperbaric oxygen therapy group. Each group was divided into 5 subgroups by 7 d, 14 d,21 d,28 d,and 35 d. And the latter four were modeled as middle cerebral artery occlusion with nylon monofilament suture. 24 hours after modeling, the hyperbaric oxygen with skilled constraint - induced movement was trained in the hyperbaric oxygen therapy with constraint - induced movement therapy group. The skilled constraint - induced movement was trained in the con- straint - induced movement therapy group, and the hyperbaric oxygen only was treated in the hyperbaric oxygen therapygroup. But the model group had no intervention. The success rates of neurologic impairment scores were analyzed and im- muno - histochemical technique was used to observe the expression of GFAP in cortical ischaemic lesions of the rats in each group at different time points. Results ： The neurologic impairment score was 0 in sham operation at each time point. At different time points after the treatment, the successful neurologic impairment scores in the CIMT with hyperbaric oxy- gen therapy group was lower than that of the model group, CIMT group and hyperbaric oxygen therapy group （P 〈 0.01 ） and there was significant difference in model group and CIMT group and hyperbaric oxygen therapy group after 28 d and 35 d （P 〈 0.05 ）, but there was no significant difference between CIMT group and hyperbaric oxygen therapy group after 35 d （P 〉 0.05）. At each time point, the expression of GFAP was significantly different between the treatment groups and model group （P 〈 0.05）. The expression of GFAP in gray matter of rats were obviously decreased in CIMT in hyper- baric oxygen therapy group compared with CIMT group and hyperbaric oxygen therapy group after 7 d, 14 d,21 d,28 d （P 〈 0.05 ）, but there was no significant difference after 35 d （ P 〉 0. 05 ）. Conclusion ： CIMT combined with hyperbaric oxy- gen therapy can restrain the expression of GFAP in cortex surrounding following focal cortical ischaemic lesions and im- prove astrocytes activity and self repairing ability of the central nervous system.