高压氧治疗急性脑梗死的疗效及对神经功能和相关细胞因子的影响研究
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摘要
目的探析高压氧治疗急性脑梗死的临床疗效,并分析对患者神经功能及有关细胞因子的影响。方法将84例急性脑梗死患者随机分为高压氧组与对照组,每组42例。对照组患者给予传统常规疗法治疗,高压氧组患者在常规治疗基础上给予高压氧治疗,治疗3周后对2组患者相关指标予以评估,采用美国国立卫生研究院卒中量表(NIHSS)评价2组患者的神经功能。观察比较2组患者的临床疗效,治疗前后患者的神经功能情况,同时比较2组患者的血清氧化修饰低密度脂蛋白(ox-LDL)、血清巨噬细胞集落刺激因子(M-CSF)以及血清可溶性细胞间粘附分子-1(sICAM-1)的水平。结果高压氧组患者与对照组的临床治疗总有效率比较差异有统计学意义(P<0.05);治疗后高压氧组患者的NIHSS评分、血清ox-LDL、M-CSF及sICAM-1水平均明显低于对照组(P<0.05)。结论高压氧治疗急性脑梗死疗效确切,显著改善了患者的神经功能以及相关细胞因子水平,可作为临床首选治疗方案。
Objective To observe the therapeutic effects of hyperbaric oxygen on acute cerebral infarction, and to investigate its effects on neurologic function and related cytokines in patients with acute cerebral infarction.Methods Eighty-four patients with acute cerebral infarction were randomly divided into hyperbaric oxygen group(n=42) and control group(n=42). The patients in control group were treated by conventional therapy,however, the patients in hyperbaric oxygen group were treated by hyperbaric oxygen on the basis of routine therapy. After 3-week treatment the neurologic function was evaluated according to National Institutes of Health Stroke scale(NIHSS),and the clinical efficacy and the neurological function before and after treatment were observed and compared between the two groups. The serum levels of oxidized low density lipoprotein(LDLX), serum macrophage colony stimulating factor(M-CSF) and serum soluble intercellular adhesion molecule-1(sICAM-1) were also observed and compared between the two groups.Results There was significant difference in total effective rate between hyperbaric oxygen group and control group(P<0.05),after treatment, the NIHSS scores, serum levels of ox-LDL M-CSF and sICAM-1 in hyperbaric oxygen group were significantly lower than those in control group(P<0.05).Conclusion Hyperbaric oxygen(HBO) is effective in treating acute cerebral infarction, which can significantly improve the neurological function and cytokine levels of the patients,and it can be used as the first choice in clinical treatment.
Objective To observe the therapeutic effects of hyperbaric oxygen on acute cerebral infarction, and to investigate its effects on neurologic function and related cytokines in patients with acute cerebral infarction.Methods Eighty-four patients with acute cerebral infarction were randomly divided into hyperbaric oxygen group(n=42) and control group(n=42). The patients in control group were treated by conventional therapy,however, the patients in hyperbaric oxygen group were treated by hyperbaric oxygen on the basis of routine therapy. After 3-week treatment the neurologic function was evaluated according to National Institutes of Health Stroke scale(NIHSS),and the clinical efficacy and the neurological function before and after treatment were observed and compared between the two groups. The serum levels of oxidized low density lipoprotein(LDLX), serum macrophage colony stimulating factor(M-CSF) and serum soluble intercellular adhesion molecule-1(sICAM-1) were also observed and compared between the two groups.Results There was significant difference in total effective rate between hyperbaric oxygen group and control group(P<0.05),after treatment, the NIHSS scores, serum levels of ox-LDL M-CSF and sICAM-1 in hyperbaric oxygen group were significantly lower than those in control group(P<0.05).Conclusion Hyperbaric oxygen(HBO) is effective in treating acute cerebral infarction, which can significantly improve the neurological function and cytokine levels of the patients,and it can be used as the first choice in clinical treatment.
引文
1 林文翠,林康,王景,等.高压氧配合药物治疗急性脑梗塞的临床分析.海南医学院学报,2015,21:1131-1133.
2 Boussi-Gross R,Golan H,Volkov O,et al.Im-provement of memory impairments in poststroke patients by hyperbaric oxygen therapy. Neuropsychology,2015,29:610.
3 Zhai X,Lin H,Chen Y,et al.Hyperbaric oxygen pre-conditioning ameliorates hypoxia-ischemia brain damage by activating Nrf2 expression in vivo and in vitro.Free radical research, 2016, 50:454-466.
4 孟庆芳,陈庆华,梁涛,等.高压氧联合脑蛋白水解物加康复疗法治疗急性脑梗死.实用医药杂志,2014,31:312-313.
5 全国第四届脑血管病学术会议.脑血管病临床疗效评定标准.中华神经科杂志,1996,29:381-382.
6 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014.中华神经科杂志,2015,48:246-257.
7 黄伟,陈肖.早期高压氧治疗对急性脑梗死患者脑能量代谢及疗效的影响.中国实用神经疾病杂志,2014,17:64-65.
8 方志豪,黄萍,张斌.高压氧治疗重型颅脑损伤的疗效分析.宁夏医科大学学报,2014,36:441-443.
9 俞宁,李通,陈琼珍.早期高压氧治疗对急性脑梗死患者脑能量代谢及疗效的影响.卒中与神经疾病,2014,21:48-50.
10 田家林,孟祥恩,张禹.早期康复与高压氧治疗急性脑梗死疗效观察.华南国防医学杂志,2015,23:15-17.
11 包永珍,曾明,吴华,等.高压氧联合上肢康复机器人训练对脑卒中偏瘫上肢运动功能的影响.中华物理医学与康复杂志,2015,37:35-37.
12 朱海清,康平,鲍智颖,等.小脑顶核电刺激联合高压氧治疗对急性脑梗死患者偏体运动功能恢复的影响.中国老年学杂志,2013,33:5982-5983.
13 罗春梅,黄梅,蒋晓静,等.高压氧治疗急性脑梗死患者脑血流动力学及神经功能损害的临床观察.重庆医学,2013,42:4318-4320.
14 徐国春.不同疗程及时间窗的高压氧治疗老年急性脑梗死的疗效.中国老年学杂志,2014,34:6888-6890.
15 冯娇,陈胡萍,曾宪容.高压氧治疗脑梗死的机制及治疗现状.西南军医,2017,19:71-75
2 Boussi-Gross R,Golan H,Volkov O,et al.Im-provement of memory impairments in poststroke patients by hyperbaric oxygen therapy. Neuropsychology,2015,29:610.
3 Zhai X,Lin H,Chen Y,et al.Hyperbaric oxygen pre-conditioning ameliorates hypoxia-ischemia brain damage by activating Nrf2 expression in vivo and in vitro.Free radical research, 2016, 50:454-466.
4 孟庆芳,陈庆华,梁涛,等.高压氧联合脑蛋白水解物加康复疗法治疗急性脑梗死.实用医药杂志,2014,31:312-313.
5 全国第四届脑血管病学术会议.脑血管病临床疗效评定标准.中华神经科杂志,1996,29:381-382.
6 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014.中华神经科杂志,2015,48:246-257.
7 黄伟,陈肖.早期高压氧治疗对急性脑梗死患者脑能量代谢及疗效的影响.中国实用神经疾病杂志,2014,17:64-65.
8 方志豪,黄萍,张斌.高压氧治疗重型颅脑损伤的疗效分析.宁夏医科大学学报,2014,36:441-443.
9 俞宁,李通,陈琼珍.早期高压氧治疗对急性脑梗死患者脑能量代谢及疗效的影响.卒中与神经疾病,2014,21:48-50.
10 田家林,孟祥恩,张禹.早期康复与高压氧治疗急性脑梗死疗效观察.华南国防医学杂志,2015,23:15-17.
11 包永珍,曾明,吴华,等.高压氧联合上肢康复机器人训练对脑卒中偏瘫上肢运动功能的影响.中华物理医学与康复杂志,2015,37:35-37.
12 朱海清,康平,鲍智颖,等.小脑顶核电刺激联合高压氧治疗对急性脑梗死患者偏体运动功能恢复的影响.中国老年学杂志,2013,33:5982-5983.
13 罗春梅,黄梅,蒋晓静,等.高压氧治疗急性脑梗死患者脑血流动力学及神经功能损害的临床观察.重庆医学,2013,42:4318-4320.
14 徐国春.不同疗程及时间窗的高压氧治疗老年急性脑梗死的疗效.中国老年学杂志,2014,34:6888-6890.
15 冯娇,陈胡萍,曾宪容.高压氧治疗脑梗死的机制及治疗现状.西南军医,2017,19:71-75