高压氧联合依达拉奉对高血压脑出血患者血清脑源性神经营养因子、脑水肿和神经功能的影响

Effects of HPO Combined with Edaravone on Serum BDNF,Encephaledema and Neurological Function of Patients with Hypertensive Cerebral Hemorrhage

目的探讨高压氧联合依达拉奉对高血压脑出血患者血清脑源性神经营养因子(BDNF)、脑水肿和神经功能的影响。方法选择南通大学附属东台人民医院2013年4月—2016年12月收治的高血压脑出血80例,根据治疗方法分为治疗组和对照组,每组40例。2组均给予微创血肿碎吸引流术,对照组在此基础上术后应用依达拉奉治疗,治疗组在对照组基础上联合高压氧治疗。观察2组治疗前后BDNF水平、神经功能情况及治疗后7、15 d脑水肿体积变化情况。结果治疗后2组BDNF水平均较治疗前升高,且治疗组高于对照组(P<0.05);2组治疗第7、15 d绝对脑水肿体积、相对脑水肿体积均小于治疗前,且治疗组小于对照组(P<0.05,P<0.01);2组治疗后美国国立卫生研究院脑卒中量表(NIHSS)评分、改良的Rankin量表(mRS)评分低于治疗前,Barthel指数量表(BI)评分高于治疗前,且治疗组改善情况优于对照组(P<0.05)。BDNF与脑水肿体积、NIHSS评分、mRS评分呈负相关(r=-0.452、-0.441、-0.512,P<0.05),与BI评分呈正相关(r=0.487,P<0.05)。结论高压氧联合依达拉奉可促进高血压脑出血患者血清BDNF的表达,改善神经功能状况,减轻脑水肿程度。

Objective To investigate effects of hyperbaric oxygenation （ HPO） combined with Edaravone on ser-um brain-derived neurotrophic factor （ BDNF ） , encephaledema and neurological function of patients with hypertensive cerebral hemorrhage. Methods A total of 80 patients with hypertensive cerebral hemorrhage admitted during April 2013 and December 2016 were divided into treatment group and control group （ n=40 for each group） . All patients received minimally invasive haematoma fluidify drainage operation, and then control group was treated with Edaravone after surger-y, while treatment group was treated with HPO therapy on the basis of treatment for control group. Results After treat-ment, BDNF levels were significantly higher than those before treatment in two groups, and the level in treatment group was significantly higher than that in control group （P〈0. 05）;on the 7th and 15th days after beginning treatment, values of absolute cerebral edema volume and relative cerebral edema volume were significantly smaller than those before treat-ment in two groups, and the values in treatment group were significantly lower than those in control group （ P〈0. 05, P〈0. 01）. After treatment, US national institutes of health stroke scale （NIHSS） and modified Rankin scale （mRS） scores were significantly lower than those before treatment, while Barthel index （ BI） scale scores were significantly high-er than those before treatment in two groups, and the improvement conditions in treatment group were better than those in control group （P〈0. 05）. BDNF was negatively correlated with cerebral edema volume, NIHSS and mRS scores （r= -0. 452, -0. 441, -0. 512, P〈0. 05）, and it was positively correlated with BI score （r=0. 487, P〈0. 05）. Conclu-sion HPO combined with Edaravone can promote serum BDNF expression, improve neurological function condition and relieve cerebral edema degree of patients with hypertensive cerebral hemorrhage.