康复训练联合高压氧对高血压脑出血术后患者脑血管动力学、血管内皮功能和血清NSE、UCH-L1、GFAP的影响

Effects of Rehabilitation Training Combined with Hyperbaric Oxygen on Cerebrovascular Dynamics,Vascular Endothelial Function and Serum NSE,UCH-L1 and GFAP in Patients with Hypertensive Cerebral Hemorrhage after Operation

目的:观察康复训练联合高压氧对高血压脑出血术后患者脑血管动力学、血管内皮功能和血清神经元特异性烯醇化酶(NSE)、泛素羧基端水解酶(UCH-L1)、神经胶质纤维酸性蛋白(GFAP)的影响。方法:按照随机数字表法将2021年3月~2022年12月我院收治的112例行微创钻孔置管引流术的高血压脑出血术后患者分为对照组(n=56,接受常规康复训练)和观察组(n=56,对照组基础上结合高压氧干预)。对比两组量表评分[日常生活能力量表-改良Barthel指数(MBI)、Fugl-Meyer运动功能评定量表(FMA)、美国国立卫生研究院卒中量表(NIHSS)]、脑血管动力学指标[平均血流量(Qmean)、外周阻力(R)、平均血流速度(Vmean)]、血管内皮功能[内皮素-1(ET-1)、一氧化氮(NO)]、血清NSE、UCH-L1、GFAP水平以及不良反应发生情况。结果:与对照组干预后相比,观察组MBI、FMA评分更高,NIHSS评分更低(P<0.05)。与对照组干预后相比,观察组Vmean、Qmean更高,R更低(P<0.05)。与对照组干预后相比,观察组NSE、UCH-L1、GFAP更低(P<0.05)。与对照组干预后相比,观察组NO更高,ET-1更低(P<0.05)。两组不良反应发生率对比未见差异(P>0.05)。结论:康复训练联合高压氧干预高血压脑出血术后患者,可有效改善脑血管动力学、血管内皮功能和血清NSE、UCH-L1、GFAP水平,减轻神经功能损伤,提高生活自理能力。

Objective:To observe the effects of rehabilitation training combined with hyperbaric oxygen on cerebrovascular dynamics,vascular endothelial function and serum neuron specific enolase(NSE),ubiquitin carboxyl terminal hydrolase(UCH-L1)and glial fibrillary acidic protein(GFAP)in patients with hypertensive cerebral hemorrhage after operation.Methods:112 patients with hypertensive intracerebral hemorrhage who underwent minimally invasive drilling and drainage surgery at our hospital from March 2021 to December 2022 were divided into a control group(n=56,receiving routine rehabilitation training)and an observation group(n=56,combining hyperbaric oxygen intervention with the control group)according to the random number table method.The scale scores[activities of daily living scale-modified Barthel index(MBI),Fugl-Meyer motor function rating scale(FMA),National Institutes of Health Stroke Scale(NIHSS)],cerebrovascular dynamics indexes[mean blood flow(Qmean),peripheral resistance(R),mean blood flow velocity(Vmean)],vascular endothelial function[endothelin-1(ET-1),nitric oxide(NO)],serum NSE,UCH-L1,GFAP levels and adverse reactions were compared between two groups.Results:Compared with control group after intervention,the MBI and FMA scores in observation group were higher,and the NIHSS score was lower(P<0.05).Compared with control group after intervention,the Vmean and Qmean in observation group were higher,and the R was lower(P<0.05).Compared with control group after intervention,NSE,UCH-L1 and GFAP in observation group were lower(P<0.05).Compared with control group after intervention,NO was higher and ET-1 was lower in observation group(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Rehabilitation training combined with hyperbaric oxygen intervention in patients with hypertensive intracerebral hemorrhage after operation,which can effectively improve cerebrovascular dynamics,vascular endothelial function and serum NSE,UCH-L1,GFAP levels,reduce neurological damage,and improve self-care ability.