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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。
Objective To evaluate the efficacy of hyperbaric oxygen (HBO) in the treatment of cerebral infarction and to investigate the effect of HBO on the blood rheology and the levels of nitric oxide (NO), superoxide dismutase-1 (SOD-1), malondialdehyde MDA, ET-1 and AngⅡ. Methods Fifty-nine patients with acute cerebral infarction were randomly divided into routine treatment group (n = 29) and conventional HBO treatment group (n = 30). The clinical curative effect, the hemorheological results and the changes of NO, SOD- -1 and Ang Ⅱ and other five indicators of changes. Results The complete recovery rate and significant improvement rate of HBO group were significantly higher than those of conventional treatment group (P <0.01). The indexes of hemorheology in HBO group showed that the whole blood viscosity, plasma viscosity, hematocrit and erythrocyte sedimentation rate were significantly lower than those before treatment (P <0.01). After treatment, serum NO levels in both groups increased compared with those before treatment, while the levels of ET-1 and AⅡ were significantly decreased. The content of NO in HBO group was significantly higher than that in the conventional group, while the levels of ET-1 and AngⅡ in the two groups were significantly lower than those in the conventional group (P <0.05). There was no significant difference in the changes of SOD-1 and MDA in this experiment. Conclusions Hyperbaric oxygen combined treatment of cerebral infarction is better than conventional treatment. The changes of serum NO, ET-1 and AngⅡ are related to the curative effect, and can be used as a reference index to determine the comprehensive effect of hyperbaric oxygen in patients with cerebral infarction.