高压氧对急性脑出血患者NSE、BDNF及sICAM-1的影响及与脑水肿相关性研究

The change of NSE, BDNF and sICAM-1 in acute cerebral hemorrhage patients by treatment of hyperbaric oxygen and its correlation with brain edema

目的：探讨高压氧对急性脑出血患者神经元特异性烯醇化酶（NSE）、脑源性神经营养因子（BDNF）及细胞间粘附分子-1（sICAM-1）的影响及与脑水肿相关性。方法：分析2015年1月～2016年6月103例在我院接受治疗的急性脑出血的患者的临床资料，对照组（54例）给予脱水降颅压、营养脑组织，改善脑循环代谢功能，维持酸碱平衡等对症支持治疗。观察组（49例）在对照组的基础上入院3天内给予高压氧治疗。结果：两组患者接受不同的治疗方案后，观察组患者血清 NSE、sICAM-1水平明显低于对照组，观察组血清 BDNF 水平明显高于对照组，差异均具有统计学意义；治疗后观察组患者相对脑水肿体积及 NIHSS 评分水平明显低于对照组；治疗后观察组患者血清 NSE 及 sICAM-1水平与相对脑水肿体积呈正相关，而血清 BDNF 与相对脑水肿体积呈负相关。结论：高压氧可明显改善急性脑出血患者脑水肿症状，促进缺损神经功能的恢复，血清 NSE、BDNF 及 sICAM-1的改变可能与脑水肿发病机制存在一定的相关性。

Objective To investigate the change of NSE, BDNF and sICAM-1 in acute cerebral hemorrhage patients by treatment of hyperbaric oxygen and its correlation with brain edema. Methods The clinical data of 103 patients with acute cer-ebral hemorrhage treated in our hospital from January 2015 to June 2016 were analyzed, Control group have 54 cases patients who were given dehydration and reduction of intracranial pressure, nutrition for brain tissue, and improve the cerebral circula-tion and metabolism function, to maintain acid-base balance and other symptomatic support therapy. The observation group have 49 cases patients who was treated with hyperbaric oxygen on the basis of the control group. Results Two groups patients received different treatment, serum NSE and sICAM-1 levels in observation group were significantly lower than the control group, the serum level of BDNF group was significantly higher than the control group, the differences were statistically signifi-cant; The relative cerebral edema volume and NIHSS score in the observation group were significantly lower than those in the control group; After treatment, the serum levels of NSE and sICAM-1 were positively correlated with the relative cerebral edema volume, while the serum BDNF was negatively correlated with the relative cerebral edema. Conclusions Hyperbaric oxygen can significantly improve the symptoms of cerebral edema in patients with acute cerebral hemorrhage, and promote the recovery of neurological deficits. The changes of serum NSE, BDNF and sICAM-1 may be related to the pathogenesis of brain edema.