目的探讨银杏二萜内酯葡胺注射液结合经筋针刺对脑卒中偏瘫患者的疗效及对血清环磷酸腺苷(cyclic adenosine phosphate,cAMP)、环磷酸鸟苷(cyclic guanosine phosphate,cGMP)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平的影响。方法选择2022年3月至2024年3月我院脑卒中偏瘫患者150例,按照随机数字表法分为观察组(常规治疗+银杏二萜内酯葡胺注射液+经筋针刺)和对照组(常规治疗+银杏二萜内酯葡胺注射液),每组75例,两组均持续治疗8周。比较两组临床疗效、血清cAMP、cGMP、BDNF、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、Fugl-Meyer运动功能评分量表(Fugl-Meyer motor function assessment,FMA)评分及中医证候积分变化。结果观察组总有效率高于对照组(88.00%vs 70.67%)(P<0.05)。观察组血清cAMP、BDNF均高于对照组(P<0.05),cGMP低于对照组(P<0.05)。观察组NIHSS评分低于对照组(P<0.05),FMA评分高于对照组(P<0.05)。观察组半身不遂、口舌歪斜、言语謇涩证候积分均低于对照组(P<0.05)。结论银杏二萜内酯葡胺注射液联合经筋针刺治疗脑卒中偏瘫效果显著,两者具有协同作用,可调节血清cAMP、cGMP、BDNF水平,促进功能恢复。
The aim of the study was to assess the distribution of connexin43 (Cx43) and connexin40 (Cx40) in human and bovine ciliary bodies. The effect of the second messengers cAMP and cyclic cGMP on Cx43 protein expression was also investigated. Enucleated human eyes (remnant after corneal transplantation) and bovine eyes were used. Tissue preparations of the anterior segments of the eyes have proceeded for immunohistochemical staining with polyclonal antibodies of Cx43 and Cx40. Isolated ciliary bodies of human and bovine eyes were incubated with cAMP analog 8-Bromo-cAMP or the cGMP analog 8-Bromo-cGMP, the expression of Cx43 protein in the tissues was then assessed by Western blot assay. Both in human and bovine ciliary bodies, strong immunoreactivity of Cx43, but not Cx40, was observed predominantly in the apical cytoplasmic portions of the pigment ciliary epithelial cells and non-pigmented ciliary epithelial cells. In human ciliary body both cAMP and cGMP up-regulated Cx43 expression, while in the bovine ciliary body, cGMP increased Cx43 expression but cAMP decreased it. Cx43 is the major component of human and bovine gap junctions in the ciliary epithelium. The regulation on the Cx43 expression by cAMP and cGMP in human and bovine ciliary bodies suggests the possibly different roles of these signal messengers in the intracellular communication.
