高压氧治疗急性缺血性脑卒中对氧化亚氮、神经元特异性烯醇酶和内皮素-1的影响

Effects of hyperbaric oxygen therapy on nitrous oxide,neuron-specific enolase and endothelin-1 in patient with acute ischemic stroke

目的观察高压氧治疗急性缺血性脑卒中的疗效及其对氧化亚氮（NO）、神经元特异性烯醇酶（NSE）和内皮素-1（ET-1）的影响。方法选择2009年1月～2012年6月在上海市第一人民医院宝山分院就诊的急性缺血性脑卒中患者90例，根据是否愿意高压氧治疗分为观察组和对照组，每组各45例。对照组予以一般的药物治疗，观察组在对照组的基础上予以高压氧治疗。观察两组治疗前、治疗2周后Fugl-Meyer运动功能（FAM）评分及改良巴氏指数（MBI）评分，血清NO、NSE和ET-1水平及疗效。结果观察组总有效率为66．67％，而对照组为35．56％，观察组疗效明显优于对照组（P〈0．01）。两组治疗后，FAM评分、MBI评分和NO水平均较治疗前明显提高（P〈0．01），观察组较对照组提高更为明显（P〈0．01）；而两组NSE和ET-1水平较治疗前明显降低（P〈0．01），观察组较对照组降低更为明显（P〈0．01）。结论高压氧治疗急性缺血性脑卒中的效果显著，可能与机体的NO水平、NSE和ET-1水平变化有关。

Objective To observe the effects of hyperbaric oxygen therapy on nitrous oxide （NO）, neuron-specific enolase （NSE） and endothelin-1 （ET-1） in patient with acute ischemic stroke. Methods 90 patients with acute ischemic stroke in Baoshan branch of the first people＇s hospital in Shanghai from January 2009 to June 2012 were selected, then divided into the observation group and the control group according to the willingness of hyperbaric oxygen therapy, each group had 45 cases. The control group was given the general drug therapy, then hyperbaric oxygen therapy in observation group was performed on the basis of the control group. The levels of FAM score, MBI score, serum NO, NSE and ET-1, curative effect before treatment and after 2 weeks treatment were observed in the two groups. Results The total effective rate was 66.67% in the observation group, which was 35.56% in the control group, the observation group was significantly better than the control group （P 〈 0.01）. The levels of FAM score, MBI score and NO after treatment significantly improved compared with before treatment in the two group （P 〈 0.01）, while the increasing levels in the observation group were more obvious than those in the control group （P 〈0.01）; the levels of NSE and ET-1 decreased significantly after treatment compared with before treatment in the two group （P 〈0.01）, and the decreasing levels in the observation group were more obvious than those in the control group （P 〈0.0l）. Conclusion The effect of hyperbaric oxygen therapy for acute ischemic stroke is obvious, its mechanism may be related to the body＇s changes of NO, NSE and ET-1.