| BackgroundParalysis as a complication with high incidence of cerebral infarction,brings tremendous mental stress and economic burden to family and social.Theory and practice of modern rehabilitation has proved that effectiverehabilitation could reduce functional disability in patients with cerebralinfarction and improve satisfaction, accelerate disease rehabilitation process,reduce the potential cost of care and save social resources. More and morestudies show that rehabilitation training can improve the prognosis ofneurological function of individuals with cerebral infarction and promotecerebral microvascular ultrastructure recovery and angiogenesis, but thespecific mechanisms of rehabilitation promoting cerebral vascularregeneration is not entirely clear. It is known that the mechanisms of adultindividuals cerebrovascular angiogenes is mainly related the bone marrowEPCs mobilization, migration and homing. Therefore, by studying dynamicchange of content of the EPCs and its migrating mediated factor SDF-1α inthe serum of hemiplegia patients with cerebral infarction under early rehabilitation treatment, this subject aims to explore the curative effect andmechanisms of early rehabilitation treatment of acute cerebral infarction, soas to provide theoretical basis for clinical application.ObjectiveTo observe the effects of early rehabilitation training on EPCs andSDF-1α of peripheral blood，and the influence of motor function in patientswith acute cerebral infarction. To explore the early rehabilitation for acutecerebral infarction efficacy and mechanisms.MethodsThis study was a prospective open-label study. Between July2013andDecember2013,50patients with a first-ever acute cerebral infarction werecontinuity included in the Department of Neurology in the First AffiliatedHospital of Chongqing Medical University. All the patients were randomlydivided into control group (n=25) and the experimental group (n=25). Twogroups of patients were given routine neurology therapy, while theexperimental group received treatment with early rehabilitation at themeantime. All patients were measured the EPCs, SDF-1α levels inperipheral blood before and after treatment, and both FMA and MBI scorewere conducted at admission and day90.ResultsThe study included patients with acute cerebral infarction50cases.There was no statistical significance between patient characteristics at baseline such as age, sex, period, the related cerebral infarction risk factorsand so on (P>0.05), the groups were comparable. There was no difference inthe levels of EPCs and SDF-1α in peripheral blood between group atbaseline[(0.47±0.11)vs(0.46±0.10),P＞0.05;（1102.48±93.39pg/ml） vs（1135.60±95.28pg/ml）,P>0.05)],buttheselevelsincreasedduringthefirstweek, thease levels showed a increment, and compared to control group, thepatients of experimental group increase more[(1.50±0.13)vs(0.75±0.09);(1810.68±110.28pg/ml)vs (1324.88±97.58pg/ml)], the difference wasstatistically significant (P<0.01). The increase amount of EPCs waspositively correlated with SDF-1α increment on day7(r=0.785,P<0.01).The FMA and MBI scores between two groups were no statistical differenceat admission, but these scores increased at day90,and experimental groupshowed a higher increment (P<0.01).Conclusions1. Early rehabilitation training can improve motor function recovery ofpatients with acute cerebral infarction;2. Early rehabilitation training can promote the mobilization of EPCs inpatients with acute cerebral infarction;3. Early rehabilitation training can increase the expression of peripheralblood SDF-1α in patients with acute cerebral infarction;4. The mechanism of early rehabilitation training on promotingmobilization of EPCs in bone marrow of patients with acute cerebral infarction may contribute to its effect of upregulating the expression level ofSDF-1α;5. Early rehabilitation training can help to improve the motor functionrecovery in patients with acute cerebral infarction,which may be related tothe promotion of EPCs mobilization,migration and homing. |
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