强制性运动联合高压氧对脑缺血大鼠神经功能及GAP-43表达的影响

目的 观察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生长相关蛋白-43 （GAP-43）表达的影响.方法 将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7d、14d、21 d、28 d和35d5个亚组,每个亚组各8只大鼠.造模24h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,分别于相应时间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GAP-43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相当（P＞0.05）.强制性运动联合高压氧组与模型组进行比较,在14、21、28 d时能够显著上调GAP-43表达（P＜0.05）,且强于CIMT组和高压氧组（P＜0.05）;在35 d缺血区周围GAP-43表达增加,但CIMT组和高压氧组差异无统计意义（P＞0.05）.结论 强制性运动联合高压氧可促进脑梗死灶周围GAP-43的表达,改善大鼠神经功能,可能与缺血损伤神经元的再生和修复有关.

Effects of Constraint-induced Movement Therapy and Hyperbaric Oxygen Therapy on Neural Function and on Expression of GAP-43 in Rats with Middle Cerebral Artery Occlusion

Objective：To investigate the effect of constraint-induced movement therapy （CIMT） and hyperbaric oxygen therapy on neural function and expression of growth associated protein（GAP-43） in rats with middle cerebral artery occlusion.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 of 7 d,14 d,21 d,28 d,and 35 d,with 8 rats in each subgroup.24 hours after modeling,model group and normal group were given ordinary feeding without any special treatment.Neurological impairment scores in other groups were analyzed and then immuno-histochemical technique was used to observe the expression of GAP-43 around infarction at different time points.Results：The neurological impairment score was 0 in sham operation at each time point.At different time points after treatment,neurological impairment scores in the CIMT with hyperbaric oxygen therapy group was lower than that of model group,CIMT group,and hyperbaric oxygen therapy group （P ＜ 0.01）,and there were significant differences in model group,CIMT group,and hyperbaric oxygen therapy group after 28 d,35 d （P＜ 0.05）,but there were no significant differences between CIMT group and hyperbaric oxygen therapy group after 35 d （P＞ 0.05）.The expression of GAP-43 in gray matter of rats obviously increased in CIMT with hyperbaric oxygen therapy group compared with model group,CIMT group,and acupuncture group after 14 d,21 d,28 d （P＜ 0.05）,but there were no significant differences between CIMT group and oxygen therapy group after 35 d（P＞0.05）.Conclusion：CIMT combined with hyperbaric oxygen therapy can restrain the expression of GAP-43 around the infarction and improve nerve function,which may be related to neuron regeneration and reconditioning.