运动疗法对急性脑梗死患者血中的脑源性神经营养因子的影响(1)
[摘要] 目的 探讨运动疗法对急性脑梗死患者血中的脑源性神经营养因子(BDNF)的影响。 方法 选取2013年9月～2014年9月解放军第三〇三医院收治的急性脑梗死患者30例，以同意运动治疗的18例为运动组，以不同意运动治疗的12例为对照组。运动组给予良肢体位摆放和被动运动，并同时给予抗血小板聚集、改善循环、营养神经、扩张脑血管等治疗。对照组只给予抗血小板聚集、改善循环、营养神经、扩张脑血管等治疗。采用酶联免疫吸附法(ELISA)检测治疗前，治疗后1、2周血液中的BDNF水平。 结果 两组治疗后BDNF水平均高于治疗前，差异有统计学意义(P < 0.05)；运动组治疗后14 d BDNF水平[(101.03±3.34)pg/mg]高于治疗后7 d[(68.12±1.41)pg/mg]，差异有统计学意义(P < 0.05)；运动组治疗后7、14 d BDNF水平均高于对照组[(66.17±1.32)、(77.15±2.29)pg/mg]，差异有统计学意义(P < 0.05)。对照组有效率(75.0%)明显低于运动组(88.9%)，差异有高度统计学意义(P < 0.01)。 结论 运动疗法可以促进DBNF的表达以及改善患者临床症状。
[关键词] 运动疗法；脑梗死；脑源性神经营养因子
[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210(2015)05(c)-0154-04
[Abstract] Objective Exercise therapy on acute cerebral infarction patients blood the effects of BDNF. Methods From September 2013 to September 2014， in the 303rd Hospital of PLA， 30 patients with acute cerebral infarction were selected， 18 patients agreed with exercise therapy were as exercise group， 12 disagreed with exercise therapy were as control group. The exercise group were given good body position and passive movement， at the same time the platelet aggregation， improve circulation， nerve nutrition， expansion and cerebrovascular treatment were given. The control group were given the platelet aggregation， improve circulation， nerve nutrition， expansion and cerebrovascular treatment. Before the treatment and after the treatment 1， 2 weeks， the BDNF of blood was detected by ELISA. Results After the treatmnet， BDNF in two groups were higher than those before the treatment， the differences were statistically significant (P < 0.05)； BDNF in exercise group after the treatment 14 days [(101.03±3.34)pg/mg] was higher than that after the treatment 7 days [(68.12±1.41)pg/mg]， the difference was statistically significant (P < 0.05)； BDNF in after the treatment 7， 14 days were higher than those in control group [(66.17±1.32)， (77.15±2.29)pg/mg]， the differences were statistically significant (P < 0.05). The effective rate of control group (75.0%) was lower than that of exercise group (88.9%)， the difference was statistically significant (P < 0.01). Conclusion Exercise therapy can promote the expression of DBNF and improve patients' clinical symptoms.
[Key words] Exercise therapy； Cerebral infarction； Brain-derived neurotrophic factor
脑卒中(stroke)如今已成为排在心血管疾病后，人类的第二号“杀手”，占因疾病死亡病例的10%，其一直都是医学界的研究热点。对于如何预防卒中的发生，目前已有较多公认的措施。但如何在卒中后恢复至今仍难以得到有效解决。缺血性脑损伤的病理机制非常复杂，有多个病理环节参与，近年来围绕缺血病理机制研究，发现许多神经保护剂和神经营养因子，其中脑源性神经营养因子(brain-derived neurotrophic factor，BDNF)可以明显促进缺血后神经元的存活和生长发育并能有效防止其受损死亡，改善神经元的病理状态，促进受损神经再生及分化成熟，在中枢神经系统损伤修复中具有重要作用[1]。运动疗法是指利用器械、徒手或患者自身力量，通过某些运动方式(主动或被动运动等)，使患者获得全身或局部运动功能、感觉功能恢复的训练方法。康复医学所要解决的最常见问题是运动功能障碍，运动疗法已成为康复治疗的核心治疗手段。本研究通过检测运动治疗后急性脑梗死患者血中的BDNF水平表达，并与未行运动治疗的性脑梗死患者血中的BDNF水平进行比较，以期观察运动疗法对急性脑梗死的疗效，为临床提供参考，现报道如下： (李婛等)
[关键词] 运动疗法；脑梗死；脑源性神经营养因子
[中图分类号] R743.3 [文献标识码] A [文章编号] 1673-7210(2015)05(c)-0154-04
[Abstract] Objective Exercise therapy on acute cerebral infarction patients blood the effects of BDNF. Methods From September 2013 to September 2014， in the 303rd Hospital of PLA， 30 patients with acute cerebral infarction were selected， 18 patients agreed with exercise therapy were as exercise group， 12 disagreed with exercise therapy were as control group. The exercise group were given good body position and passive movement， at the same time the platelet aggregation， improve circulation， nerve nutrition， expansion and cerebrovascular treatment were given. The control group were given the platelet aggregation， improve circulation， nerve nutrition， expansion and cerebrovascular treatment. Before the treatment and after the treatment 1， 2 weeks， the BDNF of blood was detected by ELISA. Results After the treatmnet， BDNF in two groups were higher than those before the treatment， the differences were statistically significant (P < 0.05)； BDNF in exercise group after the treatment 14 days [(101.03±3.34)pg/mg] was higher than that after the treatment 7 days [(68.12±1.41)pg/mg]， the difference was statistically significant (P < 0.05)； BDNF in after the treatment 7， 14 days were higher than those in control group [(66.17±1.32)， (77.15±2.29)pg/mg]， the differences were statistically significant (P < 0.05). The effective rate of control group (75.0%) was lower than that of exercise group (88.9%)， the difference was statistically significant (P < 0.01). Conclusion Exercise therapy can promote the expression of DBNF and improve patients' clinical symptoms.
[Key words] Exercise therapy； Cerebral infarction； Brain-derived neurotrophic factor
脑卒中(stroke)如今已成为排在心血管疾病后，人类的第二号“杀手”，占因疾病死亡病例的10%，其一直都是医学界的研究热点。对于如何预防卒中的发生，目前已有较多公认的措施。但如何在卒中后恢复至今仍难以得到有效解决。缺血性脑损伤的病理机制非常复杂，有多个病理环节参与，近年来围绕缺血病理机制研究，发现许多神经保护剂和神经营养因子，其中脑源性神经营养因子(brain-derived neurotrophic factor，BDNF)可以明显促进缺血后神经元的存活和生长发育并能有效防止其受损死亡，改善神经元的病理状态，促进受损神经再生及分化成熟，在中枢神经系统损伤修复中具有重要作用[1]。运动疗法是指利用器械、徒手或患者自身力量，通过某些运动方式(主动或被动运动等)，使患者获得全身或局部运动功能、感觉功能恢复的训练方法。康复医学所要解决的最常见问题是运动功能障碍，运动疗法已成为康复治疗的核心治疗手段。本研究通过检测运动治疗后急性脑梗死患者血中的BDNF水平表达，并与未行运动治疗的性脑梗死患者血中的BDNF水平进行比较，以期观察运动疗法对急性脑梗死的疗效，为临床提供参考，现报道如下： (李婛等)