CAJ | 학술논문

目的观察胞二磷胆碱结合康复训练对脑缺血大鼠运动功能及半暗带区存活素(survivin)表达的影响.方法成年雄性SD大鼠120只,采用Longa线栓法制作大鼠左侧大脑中动脉闭塞(MCAO)模型,选出造模成功后符合标准的大鼠96只随机分为对照组、药物组、康复训练组和药物结合康复训练组4组,每组大鼠24只.造模成功后第3天,对照组不做任何干预,药物组给予胞二磷胆碱(每日500 mg/kg体重),康复训练组进行滚笼、平衡木、转棒、网屏等训练,药物结合康复训练组同时采用药物组和康复训练组的方法综合治疗.4组大鼠均于造模后第7、14、21天进行神经行为学综合评分,并取脑组织采用免疫组化法观察缺血周围皮质survivin的表达.结果造模后第7,14,21天,药物组神经行为学评分与对照组同时间点比较,差异均无统计学意义(P＞0.05)；造模后第14,21天,康复训练组、药物结合康复训练组的神经行为学评分显著优于对照组和药物对照组同时间点(P＜0.05),且药物结合康复训练组造模后第14,21天的神经行为学综合评分分别为(2.75±0.50)分,(0.75±0.50)分,与康复训练组同时间点比较,差异均有统计学意义(P＜0.05).造模后第7,14,21天,药物组、康复训练组和药物结合康复训练组survivin的表达水平与对照组同时间点比较,差异均有统计学意义(P＜0.05)；药物结合康复训练组survivin的表达水平分别与药物组和康复训练组同时间点比较,差异亦有统计学意义(P＜0.05).结论胞二磷胆碱结合合理有序的康复训练能明显提高脑缺血大鼠运动功能的恢复,综合疗法效果更显著,其机制可能与缺血周围皮质survivin表达上调有关.
목적 관찰포이린담감결합강복훈련대뇌결혈대서운동공능급반암대구존활소(survivin)표체적영향.방법 성년웅성SD대서120지,채용Longa선전법제작대서좌측대뇌중동맥폐새(MCAO)모형,선출조모성공후부합표준적대서96지수궤분위대조조、약물조、강복훈련조화약물결합강복훈련조4조,매조대서24지.조모성공후제3천,대조조불주임하간예,약물조급여포이린담감(매일500 mg/kg체중),강복훈련조진행곤롱、평형목、전봉、망병등훈련,약물결합강복훈련조동시채용약물조화강복훈련조적방법종합치료.4조대서균우조모후제7、14、21천진행신경행위학종합평분,병취뇌조직채용면역조화법관찰결혈주위피질survivin적표체.결과 조모후제7,14,21천,약물조신경행위학평분여대조조동시간점비교,차이균무통계학의의(P＞0.05)；조모후제14,21천,강복훈련조、약물결합강복훈련조적신경행위학평분현저우우대조조화약물대조조동시간점(P＜0.05),차약물결합강복훈련조조모후제14,21천적신경행위학종합평분분별위(2.75±0.50)분,(0.75±0.50)분,여강복훈련조동시간점비교,차이균유통계학의의(P＜0.05).조모후제7,14,21천,약물조、강복훈련조화약물결합강복훈련조survivin적표체수평여대조조동시간점비교,차이균유통계학의의(P＜0.05)；약물결합강복훈련조survivin적표체수평분별여약물조화강복훈련조동시간점비교,차이역유통계학의의(P＜0.05).결론 포이린담감결합합리유서적강복훈련능명현제고뇌결혈대서운동공능적회복,종합요법효과경현저,기궤제가능여결혈주위피질survivin표체상조유관.
Objective To investigate the effect of drugs in combination with rehabilitative training on motor function and the expression of survivin in the ischemic penumbra after focal cerebral ischemia.Methods One hundred and twenty male,adult,Sprague-Dawley rats were subjected to left middle cerebral artery occlusion (MCAO)by suturing.Ninety-six of them were then randomly divided into a control group,a drug group,a rehabilitative trainiug group,and a drugs in combination with rehabilitative training group,with 24 in each.For three days the rats in the control group received no treatment,while those in the drug group received 500 mg/kg of citicoline daily,those in the rehabilitative training group received motor training including balancing,grasping,rotating and walking exercises,aud those in the drug and rehabilitative training group received both citicoline and the motor training.Behavioral tests were administered to all groups,and immunohistochemistry was used to detect the expression of survivin in the ischemic penumbra.Results Average behavior scores in the drug group and the control group were not significantly different at day 7,14 or 21 after the MCAO.Average behavior scores in the rehabilitative training and drug in combination with rehabilitative training groups were significantly superior to those of the control and drug groups at day 14 and 21.At those time points the average scores in the drug in combination with rehabilitative training group were also significantly better than those of the rehabilitation training group.Compared with control group,at the 7th,14th and 21st day after MCAO,expression of survivin in the other three groups had increased significantly.Expression of survivin in the group where drug treatment was combined with rehabilitative training was significantly greater than in the drug and rehabilitative training groups.Conclusions Citicoline in combination with rehabilitative training can improve the recovery of motor function in rats significantly better than the other approaches.This might be partially attributed to the up-regulation of survivin expression in the peri-ischemic cortex.