摘要目的 研究康复功能训练对大鼠脑损伤神经功能恢复及损伤边缘皮质胶原纤维酸性蛋白(GFAP)和离子钙接头分子(Iba-1)表达的影响.方法 SD大鼠131只,按随机数字表法选取30只为假手术组,其余101只制作脑损伤模型.剔除制模未达标大鼠11只,余90只按随机数字表法分为康复训练组、制动组和自由活动组,每组30只大鼠.康复训练组于术后第4天开始每天给予平衡、旋转、行走等功能训练,每项15min,共训练45min,每周6d；制动组置于网状笼内固定；自由活动组和假手术组置于普通笼内饲养.在术后第3天及术后1、2、3和4周对上述4组分别进行神经和运动功能评估,观察其恢复状况；同时采用免疫荧光染色观察损伤区边缘皮质GFAP和Iba-1的表达.结果 康复训练组术后2、3和4周在功能评估方面优于制动组和自由活动组(P＜0.05)；术后4周自由活动组较制动组的神经运动功能也有所恢复(P＜0.05).脑损伤术后2、3和4周康复训练组GFAP阳性细胞灰度值和术后3、4周康复训练组Iba-1阳性细胞平均灰度值均明显低于制动组和自由活动组(P＜0.01).结论 康复功能训练可促进大鼠脑损伤的神经功能恢复,其机制可能与损伤区边缘皮质星形胶质细胞和小胶质细胞的活化数目减少有关.

abstractsObjective To study the effectsof rehabilitative training on neural function and the expression of glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule-1 (Iba-1) in rats after traumatic brain injury.Methods A left hemisphere traumatic brain injury model was established in ninety Sprague-Dawley rats.They were then randomly divided into a rehabilitation training group,an immobilization group and a free-running group,with 30 rats in each group.Another thirty rats received sham injury as the shamoperated group.Beginning 4 days post-operation the rats of the rehabilitation training group were given balancing,rotating and walking exercises three times daily,15 min/time,6 d/week.The immobilization group was fixed in mesh cages.The rats of the free-running and sham-operated groups were reared in normal cages without any special training exercise.The rats of all 4 groups were given neural and motor function tests to assess the functional outcome.Immunofluorescence staining was used to evaluate the expressions of GFAP (the marker of astrocytes) and Iba-1 (the marker of microglia) in the cortex close to the iujured region at 3 days,1 week,2 weeks,3 weeks and 4 weeks after injury.Results The average neural and motor function test scores in the rehabilitation training group were significantly better than those in the immobilization and free-running groups at the 2nd week and thereafter.The average scores in the free-running group were significantly better than those in the immobilization group at the 4th week after injury.The immunofluorescence staining showed that the expression of GFAP was lowest in the rehabilitation group at the 2nd week and thereafter.Iba-1 expression was significantly lower only at the 3rd week and beyond.Conclusion Rehabilitative training can improve nerve function recovery in rats after traumatic brain injury,and the functional enhancement may be partially attributed to the downregulation of activated astrocytes and microglia.