高压氧联合鼠神经生长因子对高血压脑出血患者术后弥散张量成像参数的影响

Influence of hyperbaric oxygen combined with mouse nerve growth factor on postoperative diffusion tensor imaging parameters in patients with hypertensive intracerebral hemorrhage

目的 探讨高压氧联合鼠神经生长因子(mNGF)对高血压脑出血患者术后弥散张量成像(DTI)参数的影响。方法 选取2021年2月至2023年2月首都医科大学附属北京康复医院收治的96例高血压脑出血患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组48例。在常规对症治疗的基础上,对照组予以高压氧治疗,观察组予以高压氧+mNGF治疗。比较两组DTI参数[主要包括大脑脚、内囊后肢各向异性分数比值(rFA)]、神经功能[采用美国国立卫生研究院卒中量表(NIHSS)进行评估]、运动功能[采用改良Barthel指数(MBI)量表进行评估]、日常生活能力[采用简式Fugl-Meyer运动功能量表(FMA)进行评估]、炎症因子水平及不良反应发生情况。结果 治疗后两组NIHSS评分低于治疗前,FMA评分和MBI评分高于治疗前,差异均有统计学意义(P<0.05)。观察组治疗后NIHSS评分低于对照组,FMA评分和MBI评分高于对照组,差异均有统计学意义(P<0.05)。治疗后两组超敏C反应蛋白(hs-CRP)、白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)水平均低于治疗前,且观察组治疗后IL-1β、IL-10、hs-CRP水平低于对照组,差异均有统计学意义(P<0.05)。治疗后两组大脑脚rFA、内囊后肢rFA高于治疗前,且观察组治疗后大脑脚rFA、内囊后肢rFA高于对照组,差异均有统计学意义(P<0.05)。对照组与观察组不良反应发生率(8.33%vs.10.42%)比较,差异无统计学意义(P>0.05)。结论 高压氧联合mNGF可促进高血压脑出血患者神经纤维修复,提高rFA,改善神经及运动功能,降低炎症水平,促进患者术后恢复。

Objective To explore the influence of hyperbaric oxygen combined with mouse nerve growth factor(mNGF)on postoperative diffusion tensor imaging(DTI)parameters in patients with hypertensive intracerebral hemorrhage.Methods From February 2021 to February 2023,96 patients with hypertensive intracerebral hemorrhage in Beijing Rehabilitation Hospital Affiliated to Capital Medical University were selected as research objects,who were randomly divided into the control group and the observation group,48 cases in each group.On the basis of conventional symptomatic treatment,the control group was treated with hyperbaric oxygen,and the observation group was treated with hyperbaric oxygen+mNGF.The DTI parameters[mainly including fractional anisotropy ratio(rFA)of cerebral peduncle and posterior limb of internal capsule],neurological function[assessed by National Institutes of Health Stroke Scale(NIHSS)],motor function[assessed by Modified Barthel Index(MBI)scale],daily living ability[assessed by the short-form Fugl-Meyer Motor Function Scale(FMA)],inflammatory factor levels and adverse reactions between the two groups were compared.Results After treatment,the NIHSS scores in both group were lower than those before treatment,while the FMA scores and MBI scores were higher than those before treatment,with statistically significant differences(P<0.05).After treatment,the NIHSS score in the observation group was lower than that in the control group,while the FMA score and MBI score were higher than those in the control group,with statistically significant differences(P<0.05).After treatment,the levels of high sensitive C-reactive protein(hs-CRP),Interleukin-10(IL-10)and interleukin-1β(IL-1β)in both group were lower than those before treatment,moreover the levels of IL-1β,IL-10 and hs-CRP in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the cerebral peduncle rFA and posterior limb of internal capsule rFA were higher than those before treatment,and the cerebral peduncle rFA and posterior limb of internal capsule rFA in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).The incidence rate of adverse reactions between the control group and the observation group(8.33%vs.10.42%)had no statistically significant difference(P>0.05).Conclusion Hyperbaric oxygen combined with mNGF can promote nerve fiber repair,increase rFA,improve neurological and motor functions,reduce inflammation levels and accelerate postoperative recovery in patients with hypertensive intracerebral hemorrhage.