高压氧治疗对缺血性卒中患者ACA-IgG及TM水平的影响

目的 探讨高压氧治疗对缺血性卒中患者抗心磷脂抗体(ACA-IgG)及血栓调节蛋白(TM)水平的影响及其临床作用. 方法 选择广州医学院第二附属医院神经内科自2009年9月至2010年9月收治的缺血性卒中患者100例,根据TOAST分型分为3组:动脉粥样硬化血栓型组(A组)、心源性栓塞型组(B组)及小动脉病变型组(C组),依照缺血性卒中药物治疗指南采用单纯药物治疗或在其基础上联合高压氧治疗.在治疗前后应用斯堪的纳维亚卒中量表(SSS)进行神经功能缺损评分.另选择同期门诊体检健康自愿者50例做为健康对照组,采用ELISA法在治疗前后检测各组对象外周血ACA-IgG及TM水平. 结果 A、B、C组患者治疗前ACA-IgG结合指数及TM水平均较健康对照组明显增高,差异均有统计学意义(P＜0.05);B组治疗前ACA-IgG结合指数及TM水平较A、C组增高,差异均有统计学意义(P＜0.05).A、B、C组中联合高压氧治疗的患者SSS评分、ACA-IgG结合指数及TM水平均较单纯药物治疗患者明显降低,差异均有统计学意义(P＜0.05);而分别在各组患者间比较差异无统计学意义(P＞0.05). 结论 高压氧能够通过影响与凝血功能相关的ACA-IgG结合指数及TM水平,从而改善缺血性卒中患者的临床神经功能缺损程度,利于患者的神经功能康复.但针对不同病因所致的缺血性改变其效果无明显差异.

Influence of HBO therapy on level of ACA-IgG and thrombomodulin among parents with ischemic encephalopathy

Objective To investigate the role of HBO on the change of levels of ACA and thrombomodulin among parents with ischemic encephalopathy. Methods Patients were divided into three groups: group A (patients with atherosclerosis and thrombosis),group B (patients with cardiogenic embolism) and group C (patients with small artery lesion). All patients were treated with HBO and regular drugs. And then sss scores were recorded and levels of ACA-IgG and thrombomodulin were detected by ELISA before and after therapy of HBO. Results The index of ACA-IgG and lelvel of TM in A,B and C group were higher than those in control group,there are differences among them(P＜0.05),and the level of them were higher in B group than in A and C group.There were significant differences in SSS score for brain function using different therapies in A、B and C group (P＜0.05), but there are no differences among them(P＞0.05).There were differences in the index of ACA-IgG and thrombomodulin using different therapies in A,B and C group(P＜0.05),however,there were no differences among them (P＞0.05). Conclusion HBO can alleviate clinical symptoms and improve recovery of neuron by decreasing the level of ACA-IgG and thrombomodulin in blood,but the effect is not significantly different for ischemic encephalopathy caused by different factors.