重复经颅磁刺激对脑卒中后认知功能障碍患者神经功能指标和外周血NLRP3炎症小体的影响

摘要 目的：探讨重复经颅磁刺激（rTMS）对脑卒中后认知功能障碍（PSCI）患者神经功能指标和外周血Nod样受体蛋白3（NLRP3）炎症小体的影响。方法：选择2020年4月~2022年5月期间广东三九脑科医院收治的PSCI患者98例，按照随机数字表法将患者分为对照组（常规药物治疗及康复训练，n=49）和实验组（对照组基础上接受rTMS，n=49）。对比两组量表评分、神经功能指标、外周血NLRP3炎症小体。结果：治疗4周后，实验组简易智能状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）、改良Barthel指数量表（MBI）评分高于对照组（P<0.05）。实验组胶质纤维酸性蛋白（GFAP）、神经元特异性烯醇化酶（NSE）、S100β低于对照组（P<0.05）。实验组外周血NLRP3mRNA、白细胞介素-18（IL-18）、白细胞介素-1β（IL-1β）低于对照组（P<0.05）。结论：rTMS治疗PSCI，可有效减轻患者认知功能障碍，提高生活自理能力，调节患者的神经功能指标和外周血NLRP3炎症小体。

Effects of Repetitive Transcranial Magnetic Stimulation on Neurological Function Indexes and Peripheral Blood NLRP3 Inflammasome in Patients with Post-Stroke Cognitive Impairment

ABSTRACT Objective: To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on neurological function indexes and peripheral blood nod-like receptor protein 3 (NLRP3) inflammasome in patients with post-stroke cognitive impairment (PSCI). Methods: 98 PSCI patients who were admitted to Guangdong Sanjiu Brain Hospital from April 2020 to May 2022 were selected, patients were divided into control group (conventional drug therapy and rehabilitation training, n=49) and experimental group (rTMS on the basis of control group, n=49) according to the random number table method. The scale scores, neurological function indexes and peripheral blood NLRP3 inflammasome were compared between two groups. Results: 4 weeks after treatment, the scores of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and modified Barthel index (MBI) in experimental group were higher than those in control group (P<0.05). The levels of glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE) and S100β in experimental group were lower than those in control group(P<0.05). The peripheral blood NLRP3 mRNA, interleukin-18 (IL-18) and interleukin-1β (IL-1β) in experimental group were lower than those in control group (P<0.05). Conclusion: The treatment of PSCI with rTMS can effectively reduce the cognitive dysfunction of patients, improve the ability of self-care, and regulate the neurological function index and peripheral blood NLRP3 inflammasome.