高海拔地区高压氧治疗对高血压脑出血患者血清BNP及NSE含量影响的临床研究

The Clinical Research of the Effect of Serum BNP and NSE Content on Patients with Hypertensive Cerebral Hemorrhage by Hyperbaric Oxygen Therapy at High Altitude Area

目的:探讨高海拔地区高压氧治疗对高血压脑出血患者脑钠肽(BNP)及神经元特异性烯醇化酶(NSE)含量的影响。方法:选取青海省玛多县地区(平均海拔均在4 000m以上)高血压脑出血患者70例,随机分为对照组、观察组,每组35例,对两组均实施"微创术",其中对照组予以常规降血压、降颅压及神经营养等药物静点,观察组在与对照组组同等治疗的基础上于第7d病情平稳后接受高压氧治疗,在治疗一个疗程(10日)期间第1日、2日、3日、7日、10日空腹抽取静脉血,检测血清BNP及NSE含量,对照组在相应时间段内抽取静脉血检测血清BNP及NSE含量,同时选取当地35例健康者(健康组)进行体检,行静脉血BNP及NSE含量检测,三组间对比研究。结果:对照组、观察组两组患者血清BNP低于健康组,而血清NSE高于健康组;观察组在接受高压氧治疗第(1~2)日,二者含量变化与对照组相比,差异无显著性,第3日~7日,血清BNP上升及NSE的下降较对照组明显,组间差异比较有显著性;观察组接受高压氧治疗第10日时,BNP与NSE接近健康组的值,组间差异比较无显著性,而此时该两项指标在观察组与对照组、对照组与健康组相比,差异均有显著性。结论:高压氧治疗高海拔地区高血压脑出血患者,可以明显升高血清BNP含量及降低血清NSE含量,对促进患者康复,改善预后具有重要积极意义。

Objective：This article investigates the effects of the brain natriuretic peptide（BNP）and neuron specific enolization enzyme（NSE）levels from hypertensive intracerebral hemorrhage for the patients in high altitude areas.Methods：We selected 70 patients with hypertension cerebral hemorrhage in Maduo areas in Guolou prefecture of qinghai（an average elevation of over 4 000 m）.We divided them into two groups with 35 cases as controlling group and observing group.Both of the two groups are implemented by minimally invasive surgery.The controlling group was given conventional lower blood pressure,cranial pressure and neurotrophic drugs by Intravenous infusion.Based on the same therapy,the observing group was given hyperbaric oxygen therapy after 7 days＇ smooth implementation.During the first treatment period（10 days）,on the first,third,seventh and tenth day,fast venous blood was drawn to detect the contents of serum BNP and NSE,which is as same as the controlling group.Meanwhile,venous blood of 35 cases of healthy subjects（healthy group）was also detected,then we compared the content of serum BNP and NSE of three groups.Results：The serum BNP of controlling group and observing group is lower than healthy group while serum NSE is higher than the healthy group.After（1~2）days＇ hyperbaric oxygen therapy,there was no significant difference in the content changes of observing group compared with the control group.However,during the period（3~10）days of the high pressure oxygen,the up and down degree of the serum was significantly clearer than the controlling group.On the tenth day,the dgree of BNP and NSE is close to that of healthy group and the differences are significant while the two indicators between the observating group and controlling group,controlling group and healthy group,are significantly different.Conclusions：Hyperbaric oxygen is helpful to patients with high altitude hypertension cerebral hemorrhage in rising serum BNP levels and lower serum NSE levels to promote patients＇ recovery and improve the prognosis.