急诊高压氧治疗对急性脑梗死患者神经损伤程度、血管新生以及脑血流灌注的影响

Effects of emergency hyperbaric oxygen therapy on nerve injury,angiogenesis and cerebral blood perfusion in patients with acute cerebral infarction

目的:探讨急诊高压氧治疗对急性脑梗死患者神经损伤程度、血管新生以及脑血流灌注的影响。方法:2015年4月~2017年10月间在本院接受治疗的急性脑梗死患者118例作为研究对象,参照随机数表法将其分为高压氧组、对照组,各59例。对照组患者接受常规治疗,高压氧组患者在常规治疗基础上加入高压氧治疗,持续2周。对比两组患者治疗前后神经损伤程度、血管新生及脑血流灌注情况的差异。结果:确诊即刻,两组患者神经损伤程度、血管新生及脑血流灌注情况的差异不显著(P>0.05)。治疗2周后,高压氧组血清中神经损伤指标胰岛素样生长因子-1(IGF-1)、和肽素(copeptin)、多胺氧化酶(PAO)、水通道蛋白-4(AQP4)、心型脂肪酸结合蛋白(H-FABP)的含量低于对照组;血清中血管新生指标色素上皮衍生因子(PEDF)、血管形成素1(Ang-1)、血管内皮生长因子(VEGF)的含量高于对照组,内皮抑素(ES)含量低于对照组;狭窄侧脑血流灌注参数脑血流量(CBF)、脑血容量(CBV)水平高于对照组,达峰时间(TTP)水平低于对照组(P<0.05)。结论:急诊高压氧治疗可有效减轻急性脑梗死患者的神经损伤程度并促进脑血管新生、增加脑血流灌注。

Objective：To explore the effects of emergency hyperbaric oxygen therapy on nerve injury,angiogenesis and cerebral blood perfusion in patients with acute cerebral infarction.Methods：A total of 118 patients with acute cerebral infarction who were treated in the hospital between April 2015 and October 2017 were selected as study subjects and divided into hyperbaric oxygen group（n=59）and control group（n=59）by random number table method.Control group received conventional therapy,hyperbaric oxygen group received conventional therapy combined with hyperbaric oxygen therapy,and both groups were treated for 2 weeks.The differences in nerve injury,angiogenesis and cerebral blood perfusion were compared between the two groups before and after treatment.Results：Differences in nerve injury,angiogenesis and cerebral perfusion were not significant between the two groups immediately after diagnosis（P〉0.05）.After 2 weeks of treatment,serum nerve injury indexes IGF-1,Copeptin,PAO,AQP4 and H-FABP contents of hyperbaric oxygen group were lower than those of control group;serum angiogenesis indexes PEDF,Ang-1 and VEGF contents were higher than those of control group whereas ES content was lower than that of control group;stenotic-side cerebral blood perfusion parameters CBF and CBV levels were higher than those of control group whereas TTP level was lower than that of control group（P〈0.05）.Conclusion：Emergency hyperbaric oxygen therapy can effectively reduce nerve injury,promote cerebral angiogenesis and increase cerebral blood perfusion in patients with acute cerebral infarction.