高压氧对脑出血再灌注患者血管内皮生长因子及细胞黏附因子-1表达的影响

目的：探讨高压氧对脑出血再灌注患者血管内皮生长因子(VEGF)及细胞黏附因子-1(ICAM-1)表达的影响。方法回顾性分析2012年1月—2015年1月武警总医院收治的脑出血再灌注患者90例,按治疗方法不同分为两组,对照组(n=45)采取常规治疗,观察组(n=45)在常规治疗的基础上加高压氧治疗。观察两组治疗前后脑动脉(大脑中动脉、大脑前动脉、大脑后动脉)的平均血流速度、VEGF与ICAM-1水平变化及神经功能缺损评分情况。结果治疗1个疗程后,观察组大脑中、前、后动脉平均血流速度均高于对照组( P<0．05)；观察组VGEF水平高于对照组(P<0．05),ICAM-1水平低于对照组(P<0．05)；观察组神经功能损伤评分0~15分的比率为75.54%,高于对照组的44.45%(P<0．01)。结论高压氧联合常规治疗脑出血再灌注患者,能够明显促进血管VEGF表达,同时对ICAM-1表达起抑制作用,增加大脑动脉的血流速度,降低神经功能缺损评分,在一定程度上降低病死率。

Effects of Hyperbaric Oxygen on VEGF and ICAM-1 Expressions of Patients with Cerebral Hemorrhage and Reperfusion

Objective To investigate effects of hyperbaric oxygen on vascular endothelial growth factor ( VEGF) and intercellular adhesion molecule-1 ( ICAM-1 ) expressions of patients with cerebral hemorrhage and reperfusion. Methods Clinical data of 90 patients with cerebral hemorrhage and reperfusion during January 2012 and January 2015 was retrospectively analyzed, and the patients were divided into control group (n=45) taking conventional treatment and observation group (n=45) added with hyperbaric oxygen treatment on the basis of conventional treatment. Average blood flow velocity of cerebral arteries ( middle cerebral artery, anterior cerebral artery and posterior cerebral artery) , changes of VEGF and ICAM-1 levels and neurologic impairment score were observed before and after treatment in two groups. Re-sults After one course of treatment, values of middle, anterior and posterior cerebral arteries in observation group were higher than those in control group ( P <0. 05 ); compared with those in control group, VGEF level was higher ( P <0. 05), and ICAM-1 level was lower in observation group (P<0. 05); percentage of 0-15 points of neurologic impair-ment score was 75. 54% in observation group, which was higher than 44. 45% in control group (P<0. 01). Conclusion Hyperbaric oxygen combined with conventional therapy in treatment of patients with cerebral hemorrhage and reperfu-sion can significantly promote VEGF expression, inhibit ICAM-1 expression, increase blood flow velocity of cerebral ar-tery, reduce neurologic impairment score and fatality rate to a certain degree.