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目的 探讨重复经颅磁刺激 (rTMS)治疗对脑出血灶周组织单胺类和氨基酸类神经递质变化的影响 ,阐明其作用机制。方法 家兔 5 4只 ,随机分为磁刺激治疗组 (A) 2 4只 ,脑出血模型组 (B) 2 4只 ,对照组 (C) 6只。A、B组采用兔自体血注射 (0 .5ml/kg体重 )制作脑出血模型 ,C组以相同的操作方法注射生理盐水 2ml。A组家兔于造模后 12h实施rTMS ,每日 1次 ,每次 2min ;B组和C组不行rTMS。分别于造模后 12h ,2 4h ,72h和 1周时处死各组动物 ,采用高效液相色谱法检测出血灶周围脑组织中单胺类和氨基酸类神经递质的含量。结果 与C组比较 ,B组谷氨酸 (Glu)和天冬氨酸 (Asp)含量显著增高 ,甘氨酸 (Gly)和γ 氨基丁酸(GABA)含量显著降低 (均P <0 .0 1)。与B组比较 ,A组Glu和Asp含量显著降低 ,Gly和GABA含量显著增高(均P <0 .0 1) ;12h多巴胺 (DA)和 2 4～ 72h 5 羟色胺 (5 HT)含量显著增高 (P <0 .0 1) ,各时间点的去甲肾上腺素 (NA)和肾上腺素 (A)含量变化差异无显著性意义。结论 rTMS刺激可能通过调控兴奋 /抑制性氨基酸递质的平衡、促进单胺类递质的释放 ,在脑出血中发挥治疗作用
Objective To investigate the effect of repeated transcranial magnetic stimulation (rTMS) on the changes of monoamine and amino acid neurotransmitters in the perihematoma of the cerebral hemorrhage and to clarify its mechanism. Methods A total of 54 rabbits were randomly divided into 24 groups (A), 24 cerebral hemorrhage model group (B) and 6 control group (C). Groups A and B were injected intracerebral hemorrhage (0.5ml / kg body weight) into a model of intracerebral hemorrhage. Group C received normal saline 2ml in the same way. Group A rabbits were administered rTMS 12 h after model making, once a day for 2 min each time. Rats in groups B and C were not rTMS. The animals in each group were sacrificed at 12h, 24h, 72h and 1 week after modeling, respectively. The content of monoamine and amino acid neurotransmitters in the brain tissue around the blood was detected by high performance liquid chromatography. Results Compared with group C, the levels of Glu and Asp in group B were significantly increased, and the contents of Gly and GABA were significantly decreased in group B (all P <0.01) . Compared with group B, the contents of Glu and Asp in group A were significantly decreased and the contents of Gly and GABA were significantly increased in group A (all P <0.01); the levels of dopamine 12 DA and 5 HT in group 24 and 72 h were significantly increased P <0.01). There was no significant difference in the content of norepinephrine (NA) and epinephrine (A) at different time points. Conclusion The stimulation of rTMS may promote the release of monoamine neurotransmitters and may play a therapeutic role in cerebral hemorrhage by regulating the balance of excitatory / inhibitory amino acid transmitters