高压氧联合辛伐他汀治疗脑出血的效果观察

Observation on the effects of hyperbaric oxygen coupled with simvastatin on the treatment of intracerebral hemorrhage

目的 观察高压氧（hyperbaric oxygen,HBO）联合辛伐他汀治疗对脑出血患者血清白细胞介素-1β（IL-1β）含量的影响及其疗效.方法 将92例患者按患者意愿并在不违背医学伦理学的前提下分成3组,HBO组30例,辛伐他汀组32例,HBO＋辛伐他汀组30例,3组患者在常规治疗的基础上,HBO组再用HBO治疗,辛伐他汀组再用辛伐他汀,HBO＋辛伐他汀组2种方法联合使用,分别于治疗前、治疗15、30 d检测血清IL-1β含量,同时记录各阶段神经功能缺损评分和日常活动Barthel指数（BI）评分.另选31名健康体检者作为正常对照组.结果 脑出血患者血清IL-1β较正常值明显升高（P＜0.05）,HBO组、辛伐他汀组、HBO＋辛伐他汀组治疗后血清IL-1β均下降,HBO＋辛伐他汀组下降更为明显[治疗前（73.56 ±22.40） μg/L,治疗15 d（42.36±16.28） μg/L,治疗30 d（23.25 ±6.62） μg/L];治疗30 d,组间[HBO组（28.32±6.78） μg/L,辛伐他汀组（30.46±5.27） μg/L]比较差异有统计学意义（P＜0.05）;HBO组、辛伐他汀组、HBO＋辛伐他汀组神经功能缺损评分较治疗前均下降,HBO＋辛伐他汀组下降明显,组间比较差异有统计学意义（P＜0.05）;3组BI评分比较,HBO＋辛伐他汀组上升明显,差异有统计学意义（P＜0.05）.结论 HBO＋辛伐他汀联合治疗脑出血有协同和增强作用,能显著降低脑出血患者血清中IL-1β含量,使神经功能及日常生活活动能力恢复明显.

Objective To observe the effects of HBO coupled with simvastatin on the serum level of interleukin 1β （IL-1β） in patients with intracerebral hemorrhage and its therapeutic results.Methods With the consent of patients,92 patients with intracerebral hemorrhage were randomly divided into 3 groups,the HBO group （n =30）,the simvastatin group （n =32） and the HBO ＋ simvastatin group （n =30）,and another 31 examinees were designated as the control group.In addition to conventional treatment,the patients of the HBO group received HBO therapy,the patients of the simvastatin group had simvastatin and the patients of the HBO ＋ simvastatin group received combined treatment of HBO and simvastatin.Levels of IL-1 β were detected before treatment,on the 15th and 30th day after treatment,and at the same time the scores of neural function defect and Barthel index （BI） in different stages were recorded.Results The levels of serum IL-1 β in patients with intracerebral hemorrhage were obviously higher than the normal level （P ＜ 0.05）.Following treatments,the serum IL-1β levels in the patients of the above three groups were all decreased,with the serum IL-1 β level in the patients of the HBO ＋ simvastatin group decreased more prominently [before treatment （73.56 ± 22.40） μg/L,15 d after treatment （42.36 ± 16.28） μg/L and 30 d after treatment （23.25 ± 6.62） μg/L].Statistical significance could be seen,when comparisons were made between the groups [HBO group （28.32 ± 6.78） μg/L,the simvastatin group （30.46 ± 5.27） μg/L）] （P ＜ 0.05）.The scores of neural function defect in the patients of the 3 groups were all decreased,as compared with those before treatment,with that of the patients in the HBO ＋ simvastatin group decreased more significantly,and statistical significance could be noted,when comparisons were made between the groups （P ＜ 0.05）.The BI scores of the HBO ＋ simvastatin group elevated more significantly,when comparisons were made between the 3 groups,also with statistical significance （P ＜ 0.05）.Conclusions Combined treatment of intracerebal hemorrhage with HBO ＋simvastatin seemed to have synergistic and enhancing effects,which could significantly reduce the lelvels of serum IL-1β in patients with intracerebral hemorrhage,and improve the nerve function and their life activity as well.