高压氧综合治疗对急性脑梗死患者血清中肿瘤坏死因子-α及白细胞介素-1β的影响及其临床意义

目的 探讨高压氧(HBO)治疗对急性脑梗死患者血清巾肿瘤坏死因子-α(TNF-α)及白细胞介素-1β(IL-1β)的影响及其临床意义.方法 将80例急性脑梗死患者分为高压氧治疗组(HBO组)40例和常规治疗组(常规组)40例,常规组给予常规治疗,HBO组在常规治疗的基础上加用HBO治疗.另选40例健康体检者作为对照组.应用双抗体夹心酶联免疫吸附法检测HBO组和常规组治疗前后以及埘照组血清TNF-α及IL-1β的水平.于治疗前与治疗后10、30 d,采用美国国立卫生研究院脑卒中评分量表(NIHSS)对HBO组和常规组进行评分,评定其临床疗效.结果 与对照组相比,HBO组和常规组入院时血清TNF-α及IL-1β均明显增高分别为2.56±0.40,2.50±0.45;4.10±0.30,3.95±0.40;4.05±0.45,4.00±0.40(单位为μg/L,下同),P<0.01];HBO组和常规组血清TNF-α及IL-1β治疗前差异无统计学意义(P>0.05);治疗后10天均有下降分别为3.00±0.20,3.05±0.35,3.20 4±0.56,3.34±0.21,P<0.01],且HBO组低于常规组,差异有统计学意义(P<0.05,P<0.01).HBO组治疗10 d后,NIHSS评分较常规组下降;治疗30 d后,HBO组NIHSS评分明显低于常规组(分别为7.5±6.0,10.6±4.5,P<0.01).2组临床疗效比较,HBO组优于常规组(分别为77.5%和60.0%,P<0.05).结论 HBO综合治疗能显著降低脑梗死患者血清TNF-α及IL-1β的水平,提高临床疗效;HBO可能通过减轻脑梗死急性期继发的炎性损伤发挥治疗作用.

Effect and clinical significance of hyperbaric oxygen therapy on tumour necrosis factor-α and interleukin-1β in serum of patients with acute cerebral infarction

Objective To investigate the effects of hyperbaric oxygen (HBO) therapy on tumor necrosis factor -α(TNF-α) and interleukin-1β( IL-1β) in serum of patients with acute cerebral infarction and explore the clinical significances. Methods Eighty patients with acute cerebral infarction were divided into two groups:conventional therapy group(CT group) and HBO adjunctive therapy group( HBO group). Also, forty healthy people were selected as normal control group( NC group). The serum concentrations of TNF-α and IL-1β were measured by using ELISA method before and after treatment. Curative effects were evaluated by using National Institutes of Health Stroke Scale ( NIHSS) score before and after 10 and 30 days of treatment. Results In HBO and CT groups, levels of TNF-α and IL-1β were significantly higher than those in NC group value were (2.56 ±0.40) μg/L, (2.50 ±0.45) μg/L, (4. 10 ±0. 30) μg/L, (3. 95 ±0.40) μg/L, (4. 50 ±0.45)μg/L,(4.00 ±0.40) μg/L,respectively,P <0.01 ]. Also, there were no significance in levels of TNF-α and IL-1β in the two treated groups before treatment (P > 0. 05). After 10 days of treatment, levels of TNF-α and IL-1β were decresed and those in HBO group were lower than those in CT group( P < 0.05,P < 0.01). At the same time, the scores of NIHSS were decresed obviously ( P < 0. 01 ) after 10 and 30 days of treatment. Conclusions HBO therapy can decrease the levels of TNF-α and IL-1β by reducing the secondary inflammatory reaction in early cerebral infarction.