陈瑞芳，罗勇，汶海琪，谢宸宸，庞月珊.早期康复训练对脑梗死偏瘫患者外周血内皮祖细胞和基质细胞衍生因子1α含量及运动功能恢复的影响[J].中华物理医学与康复杂志,2016,38(2):81-85
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| 早期康复训练对脑梗死偏瘫患者外周血内皮祖细胞和基质细胞衍生因子1α含量及运动功能恢复的影响 |
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| DOI： |
| 中文关键词: 脑梗死 康复训练 内皮祖细胞 基质细胞衍生因子 1α |
| 英文关键词: Cerebral infarction Rehabilitation Endothelial progenitor cells Stromal cell derived factor 1α |
| 基金项目:重庆市卫生局中医药科技重点项目（ZY20131027）；教育部高等学校博士学科点专项科研基金联合资助课题(20095503110001) |
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| 中文摘要: |
| 目的观察早期康复训练对急性脑梗死偏瘫患者外周血内皮祖细胞（EPCs）、基质细胞衍生因子1α（SDF 1α）含量及运动功能恢复的影响。 方法入选首次发病48h内的急性脑梗死偏瘫患者50例，按随机数字表法分成对照组和治疗组，每组25例。2组患者均给予神经内科常规药物治疗，治疗组在药物治疗基础上给予早期康复训练。所有患者均在治疗前和治疗1周后，分别采用流式细胞仪检测外周血EPCs相对数量，采用酶联免疫吸附试验法检测外周血SDF 1α含量；并于治疗前和治疗3个月后，采用简易Fugl Meyer评分法和改良Barthel指数评分法，对患者进行FMA及MBI评分。 结果①治疗前，对照组与治疗组患者的外周血EPCs相对数量和SDF 1α含量比较，差异无统计学意义（P>0.05）。经治疗1周后，2组患者的外周血EPCs和SDF 1α均较治疗前明显升高，且治疗组EPCs相对数量［(1.50±0.13)%］和SDF 1α含量［(1810.68±110.28)pg/ml］较对照组升高更为明显，差异有统计学意义(P<0.01)。②Spearman等级相关分析显示，2组患者治疗前后EPCs增加量与SDF 1α增加量呈正相关（r=0.785，P<0.01）。③2组患者治疗前FMA和MBI评分差异无统计学意义（P>0.05），治疗3个月后上述评分均较治疗前改善，且治疗组FMA［(59.40±17.39)分］和MBI［(64.08±15.22)分］较对照组改善更为明显，差异均有统计学意义（P<0.01）。 结论早期康复训练有助于进一步改善急性脑梗死偏瘫患者运动功能预后，治疗机制可能与其上调外周血SDF 1α进而促进骨髓EPCs动员有关。 |
| 英文摘要: |
| Objective To observe the effects of early rehabilitation training on endothelial progenitor cells (EPCs), stromal cell derived factor alpha 1 (SDF 1α) and motor function recovery in hemiplegic patients with acute cerebral infarction. MethodsFifty hemiplegic patients after a first acute cerebral infarction were randomly divided into a control group (n=25) and an experimental group (n=25). Both groups of patients were given routine drug therapy, while the experimental group also received early rehabilitation (within 48 hours of onset). EPCs and SDF 1α levels in peripheral blood were measured before and after one week of treatment, and Fugl Meyer assessments and modified Barthel index scoring were conducted at admission and after three months of treatment. ResultsThere was no difference between the 2 groups before the treatment. After a week of treatment, however, the EPC and SDF 1α values of both groups had increased, with those of the experimental group increasing significantly more than in the control group. Spearman rank correlation analysis showed that the increase in EPCs was positively correlated with the SDF 1α increment in the first week. After 3 months of treatment, the average FMA and MBI results of the experimental group were significantly better than those of the control group. ConclusionEarly rehabilitation training can help to further improve the recovery of motor function for hemiplegic patients after acute cerebral infarction. This may be related to its effect in upregulating the expression of SDF 1α, thus contributing to the mobilization of EPCs in the bone marrow. |
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