目的：：研究川芎嗪(tetramethylpyrazine,TMP)联合骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)对脑缺血大鼠神经细胞凋亡及Bcl-2、Bax表达的影响。方法：采用全骨髓贴壁法体外培养BM-SCs,传代至第3代用于尾静脉移植。采用线栓法诱导大鼠右侧大脑中动脉阻塞模型,除假手术组外,大鼠随机分为模型组、BMSCs(1×109/L)组、川芎嗪(40 mg/kg)组和联合(川芎嗪+BMSCs)组,每组12只。缺血后第1、7和14天采用改良的神经损伤严重程度评分( modified neurological severity scoring,mNSS)进行神经功能评价。缺血后第14天,甲苯胺蓝染色检测脑梗死体积,HE染色观察脑组织病理学变化,采用原位末端标记( TUNEL)法观察神经细胞凋亡数,采用实时荧光定量PCR法和Western blot法检测Bax和Bcl-2的mRNA及蛋白表达。结果：与BMSCs组和川芎嗪组比较,联合组mNSS评分显著减少(P<0．01),梗死体积显著减少(P<0．01),缺血引起的脑缺血周边区病理性损伤明显减轻,TUNEL阳性细胞数显著减少(P<0．01),Bcl-2的mRNA及蛋白表达显著增加,Bax的mR-NA及蛋白表达显著降低(P<0．01)。结论：川芎嗪联合BMSCs移植能显著促进脑缺血后大鼠的功能恢复,减少梗死体积,减轻脑组织缺血性损伤,抑制神经细胞凋亡,机制可能与调控Bcl-2和Bax的表达有关。%[ ABSTRACT] AIM:To investigate the effects of tetramethylpyrazine ( TMP) combined with bone marrow mesen-chymal stem cells ( BMSCs) on neuronal apoptosis, and Bcl-2 and Bax expression in rats with cerebral ischemia. METH-ODS:The BMSCs were isolated by the whole bone marrow adherent method and cultured, and those in the 3rd passage were used for tail-vein transplantation. The rats were subjected to right middle cerebral artery occlusion ( MCAO) using su-ture method, and the rats except sham group were randomly divided into model group, BMSCs (1 × 109 cells/L) group, TMP (40 mg/kg) group and combination (TMP+BMSCs) group with 12 rats in each group. Neurological function was e-valuated by modified neurological severity scoring ( mNSS) on 1 d, 7 d and 14 d after cerebral ischemia. Toluidine blue staining was performed to detect cerebral infarct volume, HE staining was used to observe brain histopathological change, neuronal apoptosis was observed by TUNEL staining, and the mRNA and protein expression of Bcl-2 and Bax was detected by real-time fluorescence quantitative PCR and Western blot at 14 d after cerebral ischemia. RESULTS: Compared with BMSCs group and TMP group, TMP combined with BMSCs significantly reduced the score of mNSS (P<0. 01) and the in-farct volume ( P<0. 01 ) , alleviated the pathological damage in the peripheral area of cerebral ischemia, decreased the number of TUNEL positive cells (P<0. 01), increased the expression of Bcl-2 and decreased the expression of Bax at mR-NA and protein levels ( P<0. 01 ) . CONCLUSION: Tetramethylpyrazine combined with transplantation of BMSCs im-proves the functional recovery, reduces the infarct volume, relieves the ischemic injury of the brain tissue, and attenuates neuronal apoptosis in the rats with cerebral ischemia. The mechanism may be related to regulating the expression of Bcl-2 and Bax.
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