【摘要】 目的:康复训练促进脑梗死后神经功能恢复已成共识,而其确切机制目前尚不明了,综述康复训练对脑梗死大鼠脑组织结构与功能恢复的影响,归纳其可能的作用途径。资料来源:应用计算机检索Medline2000-01/2005-10期间与脑梗死或脑缺血、康复训练和大鼠相关文献,检索词:“cerebralischemiaorcere-bralinfarction,rehabilitationtrainingorphysicaltraining,rat”,并限定语言种类为English,以及中国期刊全文数据库、中文科技期刊数据库2000-01/2005-10期间的文章,限定文章语言种类为中文,检索词“脑梗死,康复训练,大鼠”。资料选择:纳入标准:对资料进行初审,选择包含康复训练对脑梗死大鼠脑组织结构与功能恢复影响的基础研究文章,排除标准:筛除综述类及与临床研究的文章。资料提炼:选出以康复训练对脑梗死或脑缺血大鼠为研究对象的文章65篇,通过阅读摘要或全文对文章内容进行分类整理,其中17篇与综述内容关系密切,17篇论著中包含:关于康复训练对脑梗死大鼠脑组织结构可塑性的影响8篇;关于神经功能的重组和提高3篇;相关蛋白质和基因组学的作用及其机制6篇。因论述侧重点及内容相似等原因排除48篇。资料综合:①脑梗死后的康复训练可使与梗死脑组织毗邻的脑区发生适应性可塑性改变,齿状回神经前体细胞增殖,星形胶质细胞增多,突触数目增加,传导功能增强,结构更精细。②康复训练有利于脑梗死体积的缩小,改善对侧大脑和梗死区周围的血液供应。③康复训练可明显促进脑梗死鼠肢体运动功能和学习记忆能力的恢复。④康复训练促进脑梗死后多种神经保护性因子的表达,使组织修复、神经细胞及其突触再生的标志性因子表达上调。这些蛋白质因子表达上调,从不同角度反映了康复训练可促进大鼠脑梗死后神经功能的恢复,同时也揭示了康复训练促进脑梗死后神经功能恢复的机制。结论:康复训练可促进脑梗死后大鼠肢体运动功能及学习记忆能力恢复,使梗死灶体积缩小,增强健存脑组织的突触可塑性,提高脑组织内保护性蛋白因子的基因表达。更多还原

【Abstract】 OBJECTIVE: It is agreed that the rehabilitation training results in neural functional recovery after cerebral infarction,while its defined mechanism is not clear at present. To review the effects of rehabilitation training on the brain tissue structure and function recovery in rats with cerebral infarction and summarize its possible mechanism. DATA SOURCES: A computer-based online search of Medline database was undertaken to identify articles about rehabilitation training and rats of cerebral infarction or cerebral ischemia published from January 2000 to October 2005 by using the keywords of "cerebral ischemia or cerebral infarction,rehabilitation training or physical training,rat" in English. At the same time,Chinese relevant articles were searched in China Journal Full-tooxt Database (CJFD) Chinese technology periodical database published between January 2000 and October 2005 with the keywords of "cerebral infarction,rehabilitation training,rats". STUDY SELECTION: Inclusive criteria: the data were selected firstly,and all articles related to the influence of rehabilitation training on brain tissue structure and functional recovery in rats with cerebral infarction were selected. Exclusive criteria: reviews and clinical research articles were excluded. DATA EXTRACTION: Totally 65 articles of rats with cerebral infarction or cerebral ischemia with rehabilitation training. After reading abstract or full-text,the contents of these articles were classified and arranged,of which 17 articles were associated with reviews. These articles contained 8 articles on effect of rehabilitation training on brain tissue structure plasticity in rats with cerebral infarction,3 articles about recombination and elevation of neurofunction,6 articles on effect and its mechanism of protein and genomics. Thus,48 articles were excluded because of the key of discussion and similar content. DATA SYNTHESIS: 1Rehabilitation training after cerebral infarction could make brain region adjacent to infarcted cerebral tissues change adaptively and plastically,nerve precursor cells in dentate gyrus proliferate,astrocytes increase,number of synapsis increase,conductive function strengthen and structure refine. 2The rehabilitation training was good for the minification of cerebral infarcted volume,improves the blood supply at opposite brain and infarcted region. 3The rehabilitation training could markedly accelerate the recovery of limb motor function and learning memory function in rats with cerebral infarction. ④The rehabilitation training could enhance the expression of multiple neuroprotective factors after cerebral infarction,which induced tissue repair,up-regulation of marked factors expression of nerve cells and its regenerated synapsis. These up-regulation of protein factors reflected that the rehabilitation training could accelerate the recovery of neural function in rats after cerebral infarction from different angles,at the same time,it also showed that the mechanism of rehabilitation training facilitating neural functional recovery after cerebral infarction. CONCLUSION: The rehabilitation training can promote recovery of limb motor function and ability of learning and memory in rats after cerebral infraction,shorten infarcted volume,increase synaptic plasticity of survival cerebral tissue,and increase the genetic expression of protective protein factor in brain tissues.更多还原