高压氧对重型颅脑损伤患者血清炎性因子、氧化应激、内皮素及颅内压的影响

Effects of hyperbaric oxygen on serum inflammatory factors,oxidative stress,endothelin and intracranial pressure in patients with severe head injury

目的:探讨高压氧(HBO)对重型颅脑损伤(STBI)患者血清炎性因子水平、氧化应激状态,血管内皮细胞功能及颅内压的影响,为临床治疗重型颅脑损伤患者提供科学依据。方法:选取STBI患者110例,依据随机数据表法将其分为对照组和治疗组,每组各55例。对照组行常规综合治疗,观察组在对照组基础上给予HBO治疗,观察并比较两组患者治疗前及治疗10d后患者的炎性因子(CRP、TNF-α、IL-6及IL-10)、氧化应激(MDA及SOD-1)、内皮素(ET)及颅内压(ICP)水平变化。结果:治疗组与对照组患者治疗后的CRP、TNF-α、IL-6、MDA、ET及ICP水平较同组治疗前均显著降低(P<0.05),且观察组治疗后CRP、TNF-α、IL-6、MDA、ET及ICP水平均显著低于对照组治疗后(P<0.05);治疗后两组患者的IL-10及SOD-1水平较同组治疗前均显著升高(P<0.05),且观察组治疗后两者水平显著高于对照组治疗后(P<0.05)。结论:HBO治疗重型颅脑损伤患者效果显著,可以有效减轻氧化应激损伤和炎症反应,改善患者血管内皮细胞功能,降低颅内压,具有一定的临床价值。

Objective：To investigate the effect of hyperbaric oxygen（HBO）on serum inflammatory factors,oxidative stress status,endothelial cell function and intracranial pressure in patients with severe craniocerebral injury（STBI）,and to provide scientific basis for clinical treatment of patients with severe craniocerebral injury.Methods：A total of 110 cases of STBI were selected and divided into control group and treatment group according to the random data table,with 55 cases in each group.The control group received conventional combined therapy,the observation group were given HBO treatment on the base of the control group,the inflammatory factors（CRP,TNF-α,IL-6and IL-10）and oxidative stress（MDA and SOD-1）,endothelin（ET）and intracranial pressure（ICP）level changes of the two groups were observed and compared before and after treatment for 10 din patients.Results：The levels of CRP,TNF-α,IL-6,MDA,ET and ICP in the treatment group and the control group were significantly lower than those in the same group before treatment（P 0.05）;the CRP,TNF-α,IL-6,MDA,ET and ICP levels of the observation group after treatment were significantly lower than the control group after treatment（P〈0.05）.After treatment,IL-10 and SOD-1levels of the two groups of patients were significantly increased than the same group before treatment（P〈0.05）,and both levels in the observation group after treatment was significantly higher than the control group after treatment（P 0.05）.Conclusions：HBO treatment of severe brain injury patients with significant effect,can effectively reduce oxidative stress damage and inflammation,improve patients＇ endothelial cell function,and reduce intracranial pressure,thus it has a certain clinical value.