强制性运动康复训练对脑梗死大鼠神经功能及巢蛋白表达的影响

Effects of rehabilitation with constraint-induced movement therapy on neural function and nestin expression in rat cerebral infarction model

目的：探讨不同时间的强制性运动康复训练对脑梗死大鼠神经功能评分及梗死灶周围巢蛋白（nestin）表达的影响。方法：将160只雄性SD大鼠随机分为正常组、假手术组、模型组、治疗组,各组再根据术后开始干预的时间窗细分为术后6、12、24、48及72 h 5个亚组,每组8只。治疗组给予强制性运动康复训练,其他各组正常饲养。14 d后进行神经功能缺失评分,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nestin的表达。结果：正常组及假手术组大鼠各时间点均无神经功能缺失表现;脑梗死后6-72 h,治疗组神经功能缺失评分均低于模型组（P〈0.05）;模型组和治疗组6-72 h时间点评分差异均无统计学意义（P〉0.05）;正常组及假手术组大鼠脑梗死后6-72 h nestin阳性细胞数均明显少于模型组及治疗组（P〈0.01）;而治疗组各时间点的nestin阳性细胞数亦明显高于其他各组（P〈0.01）;正常组、假手术组及模型组内各不同时间点nestin阳性细胞数差异均无统计学意义（P〉0.05）;治疗组内梗死后24 h nestin阳性细胞数均高于其他各时间点（P〈0.05）。结论：强制性运动康复训练的最佳时机为脑梗死后24 h;其机制可能与增加脑梗死灶周围神经干细胞的增殖及分化有关。

Objective： To investigate the effect of rehabilitation with constraint-induced movement therapy（ CIMT） at different times on neural function and observe the expression of nestin after middle cerebral artery occlusion in rat model. Methods： One hundred and sixty healthy male SD rats were randomly divided into 4 groups： normal group,sham operation group,model group and treatment group.The rats in each group were divided into 5 subgroups by 6 h,12 h,24 h,48 h and 72 h,8 rats in each group. The rats in treatment group were treated with rehabilitation with CIMT,while the rats in other groups were treated with normal feeding. The success rate of neurologic impairment scores was analyzed and the expression of nestin in cortical ischaemic lesion was observed by immunohistochemical technique after 14 days. Results： After cerebral infarction for 6 to 72 h,the rats in normal and sham operation groups were no nerve defect performance at each time point,but the scores of nerve function defect in treatment group were lower than the scores in model group（ P〈0. 05）; there was no statistical significance of nerve function defect scores in model group and treatment group at 6 to72 h interval time differently（ P〉0. 05）; the positive cell number of nestin in normal and sham operation groups was significantly less than that in model and treatment groups after cerebral infarction for 6 to 72 h（ P〈0. 01）,and the positive cell number in treatment group was significantly higher than that in other groups at different time points（ P〈0. 01）; there was no statistical significance of positive cell number at different time points among normal,sham operation and model groups（ P〉0. 05）; and the positive cell number of nestin after cerebral infarction for 24 h was higher than that at other time points in treatment group（ P〈0. 05）. Conclusions： The best time to do compulsory rehabilitation training was after cerebral infarction for 24 h in rat; the mechanism may be related to increase infarct peripheral nerve stem cell proliferation and differentiation.