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背景:临床研究表明小脑顶核电刺激能改善脑梗死患者的神经功能,小脑顶核电刺激的效果是否与抗凋亡蛋白有关。目的:通过观察急性脑梗死患者小脑顶核电刺激前后体内的抗凋亡蛋白sAPO-1/Fas及Bcl-2的含量变化,进一步探讨小脑顶核电刺激治疗脑梗死的机制。设计:以诊断为依据,随机对照研究。单位:重庆医科大学附属第一医院神经内科。对象:2000-01/12重庆医科大学附属第一医院神经内科住院发病3d内的急性脑梗死患者40例,随机分为刺激组及对照组,每组20例。干预:对照组仅给予常规药物治疗;刺激组在常规药物治疗基础上加用小脑顶核电刺激,2次/d,45min/次,连续10d。主要观察指标:采用ELISA方法测定小脑顶核电刺激前后血清及脑脊液中sAPO-1/Fas,Bcl-2含量。结果:①小脑顶核电刺激10d后的脑脊液sAPO-1/Fas含量为(81.47±13.28)ng/L,较刺激前52.47±14.32)ng/L明显升高,也明显高于(对照组(44.19±12.16)ng/L。②小脑顶核电刺激10d后的血清Bcl-2含量较刺激前明显增高,并显著高于对照组。结论:在脑梗死急性期给予小脑顶核电刺激可提高体内的抗凋亡蛋白sAPO-1/Fas及Bcl-2含量,可能是小脑顶核电刺激治疗脑梗死机制之一。
BACKGROUND: Clinical studies show that cerebellar fastigial electrical stimulation can improve the neurological function in patients with cerebral infarction. Whether the stimulation of cerebellar fastigial nuclei is related to anti-apoptotic proteins. OBJECTIVE: To investigate the changes of sAPO-1 / Fas and Bcl-2 in anti-apoptotic proteins in patients with acute cerebral infarction before and after electrical stimulation of the cerebellar fastigial nucleus, and to explore the mechanism of cerebellar fastigial nucleus stimulation in cerebral infarction. Design: Based on diagnosis, randomized controlled study. Unit: Department of Neurology, the First Affiliated Hospital of Chongqing Medical University. PARTICIPANTS: Forty patients with acute cerebral infarction within 3 days after hospitalization admitted to Department of Neurology, the First Affiliated Hospital of Chongqing Medical University from January 2000 to December 2000 were randomly divided into stimulation group and control group with 20 cases in each group. Intervention: the control group was given only conventional drug therapy; the stimulation group was treated with cerebellar fastigial nucleus stimulation twice a day for 45 min every time for 10 days. MAIN OUTCOME MEASURES: The levels of sAPO-1 / Fas and Bcl-2 in serum and cerebrospinal fluid were measured by ELISA before and after stimulation of cerebellar fastigial nucleus. Results: ① The content of sAPO-1 / Fas in cerebrospinal fluid of the fastigial nucleus after stimulation for 10 days was (81.47 ± 13.28) ng / L, which was significantly higher than that before stimulation (52.47 ± 14.32) ng / L ± 12.16) ng / L. ② The level of Bcl-2 in the fastigium group was significantly higher than that in the control group after 10 days of electrical stimulation of the cerebellar fastigial nucleus.Conclusion: Electrical stimulation of cerebellar fastigial nucleus in the acute phase of cerebral infarction can increase the in vivo anti- The apoptosis proteins sAPO-1 / Fas and Bcl-2 levels may be one of the mechanisms of cerebellar fastigial stimulation in the treatment of cerebral infarction.