高压氧治疗急性脑梗死的临床观察及对相关实验指标的影响

目的评价高压氧（HBO）治疗脑梗死的效果,并探讨HBO治疗对脑梗死患者血液流变学及一氧化氮（NO）、超氧化物歧化酶-1（SOD-1）、丙二醛（MDA）、血浆内皮素-1（ET-1）及血管紧张素Ⅱ（AngⅡ）等指标的影响。方法59例急性脑梗死患者随机分为常规治疗组（29例）和常规HBO治疗组（30例）,观察两组临床疗效、治疗前后血液流变学结果及NO、SOD-1、MDA、ET-1及AngⅡ等5项指标变化情况。结果HBO组基本痊愈率及显著进步率明显高于常规治疗组（P〈0.01）;HBO组血液流变学指标提示全血粘度、血浆粘度、红细胞压积和血沉与治疗前相比均明显降低（P〈0.01）;治疗后两组血清NO含量较治疗前增加,而ET-1和AⅡ则明显降低,HBO组NO含量明显高于常规组,而ET-1和AngⅡ则显著低于常规组（P〈0.05）;本实验中SOD-1、MDA的变化差异无统计学意义。结论高压氧综合治疗脑梗死效果明显优于常规治疗;血清NO、ET-1和AngⅡ含量变化与疗效有关,可作为脑梗死患者高压氧综合疗效判定的参考指标。

Clinical effects of hyperbaric oxygen and its influence to the relative laboratory parameters in treating acute cerebral infarction

Objective To evaluate the effects of hyperbaric oxygen（HBO） in treating acute cerebral infarction and investigate the effects of nitric oxide（ NO）, superoxide dismutase - 1 （ SOD - 1 ）, malonic dialdehyde（ MDA）, endothelin - 1 （ ET - 1 ）, angiotensin Ⅱ （ Ang Ⅱ ） in patients with acute cerebral infarction treated by HBO and its value of application. Methods Fifty - nine patients with acute cerebral infarction were randomly divided into two groups： HBO treatment group （ n = 30） and routine treatment group （ n = 29 ）. Clinical effects of the two groups were observed and the results of hemorrheology as well as 5 laboratory parameters include NO, SOD- 1, M DA, ET- 1 and Ang 11 were measured before and after treatment. Results In HBO group, the recovery rate and effective rate were significantly higher than those in routine therapy group （ P 〈 0.01 ）. The parameters （whole blood viscosity and plasma viscosity ） for hemorheology in HBO group were obviously decreased than those before HBO treatment （ P 〈0.01 ）. The concentration of NO increased , while both ET- 1 and Ang Ⅱ decreased in both groups after treatment, but the concentration of NO in HBO group was significantly higher , while ET - 1 and Ang Ⅱ were significantly lower than those of routine group（ P 〈 0.05 ）. Meanwhile the changes of SOD - 1 and MDA had no significant difference after treatment. Conclusion HBO therapy is more effective than pure drug therapy in treating patients with acute cerebral infarction. The changes of concentration of NO ,ET - 1 and Ang Ⅱ were related with therapeutic effects, they can be used as references for evaluation the degree of cerebral infarction and prognosis during the treatment of HBO.