不同疗程高压氧联合舍曲林治疗对脑出血患者睡眠障碍及血清神经损伤因子的影响

Effects of different courses of hyperbaric oxygen combined with sertraline on sleep disorders and serum neurologic injury factors in patients after cerebral hemorrhage

目的分析不同疗程高压氧联合舍曲林治疗对脑出血患者睡眠障碍及血清神经损伤因子水平的影响。方法选取2016年10月至2020年1月武威市人民医院神经内科120例脑出血后睡眠障碍患者,按照数字表法随机分为对照组与观察组,每组60例。对照组采用舍曲林治疗,观察组在对照组基础上采用高压氧治疗。比较2组患者治疗前及治疗后10、20、30 d睡眠质量,临床疗效,治疗前及治疗后10、20、30 d血清神经元特异性烯醇化酶(NSE)、细胞间黏附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)水平。结果治疗后不同时间观察组患者匹斯堡睡眠质量指数量表(PSQI)评分均显著低于对照组(P<0.05),睡眠总时间、深睡眠总时间、快速眼球运动睡眠时间(REM)均显著长于对照组(P<0.05),睡眠潜伏期均显著短于对照组(P<0.05);随着疗程的延长,2组患者PSQI评分均呈降低趋势(P<0.05),睡眠总时间、深睡眠总时间、REM均呈延长趋势(P<0.05),睡眠潜伏期均呈缩短趋势(P<0.05)。治疗后10、20、30 d观察组患者临床总有效率均显著高于对照组(P<0.05);随着疗程的延长,2组患者临床总有效率均呈上升趋势(P<0.05);治疗后不同时刻观察组患者血清NSE、ICAM-1、TNF-α水平均显著低于对照组(P<0.05);随着疗程的延长,2组患者上述指标均呈降低趋势(P<0.05)。结论增加高压氧疗程并联合舍曲林可改善脑出血后睡眠障碍患者睡眠质量,提高临床治疗效果。

Objective To analyze the effects of different courses of hyperbaric oxygen combined with sertraline on sleep disorders and serum neurologic injury factors in patients after cerebral hemorrhage.Methods A total of 120 patients with sleep disorders after cerebral hemorrhage were divided into control group(n=60)and observation group(n=60)by random number table method.The control group was treated with sertraline only,while the observation group was treated with hyperbaric oxygen on the basis of the treatment in the control group.The sleep quality,clinical efficacy,the levels of serum neuron-specific enolase(NSE),intercellular adhesion molecule-1(ICAM-1),and tumor necrosis factor-α(TNF-α)before and 10,20,and 30 d after treatment were compared between the two groups.Results The scores of Pittsburgh sleep quality index(PSQI)of the observation group were significantly lower than those of the control group at every time point of treatment(P<0.05);the total sleep time,total deep sleep time,total light sleep time,and rapid eye movement(REM)sleep time of the observation group were significantly longer than those of the control group(P<0.05);and the sleep latency of the observation group was significantly shorter than that of the control group(P<0.05).With the prolongation of the treatment course,the PSQI scores of both groups showed decreasing trends(P<0.05);the total sleep time,total deep sleep time,total light sleep time,and REM sleep time of both groups tended to prolong(P<0.05);and the sleep latency tended to be shorter(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group at 10,20,and 30 d after treatment(P<0.05).With the prolongation of the treatment course,the total effective rates of the two groups showed increasing trends(P<0.05);the levels of serum NSE,ICAM-1,and TNF-αin the observation group were significantly lower than those in the control group at every time point of treatment(P<0.05);and with the prolongation of the treatment course,the above indicators of the two groups showed decreasing trends(P<0.05).Conclusion Hyperbaric oxygen therapy combined with sertraline can improve the sleep quality and clinical efficacy of patients after cerebral hemorrhage with sleep disorders.