摘要
目的对脑栓塞患者在发病后不同时间段进行高压氧(HBO)治疗的疗效进行研究。方法将2004年6月至2006年2月期间入院,NIHSS评分在5分以上,起病时间不超过48h的脑栓塞患者,随机分为HBO A组、HBO B组和对照组(C组)。A组为起病48h内进行常规治疗同时进行HBO治疗;B组为先行常规治疗,起病15d后再行HBO治疗;而C组只进行常规治疗。各组治疗1个疗程(5d)后以NIHSS评分评价疗效;治疗90d后以改良Rankin评分(预后优良者,评分0～1分)评价疗效。3组患者均于症状达高峰后3d内和相隔21d后两次抽血,测定血浆中超氧化物歧化酶(SOD)和丙二醛(MDA)的含量。结果各组治疗1个疗程后,3组NIHSS评分比较差异无统计学意义(P>0.05)。90d后,A组28例患者中11例预后优良,对照组28例只有2例预后良好,而B组28例中5例取得良好预后。3组患者治疗后血浆中MDA均有下降,其中A组下降最多。3组患者血浆中SOD含量,治疗后均有升高,但3组间比较差异无统计学意义(P>0.05)。结论脑栓塞患者急性期进行HBO治疗,疗效较单纯常规治疗更好。HBO治疗对康复期患者仍然有效,但效果比在急性期积极进行HBO治疗差。HBO干预,能降低血浆中MDA含量,且越早效果越好。
Objective To investigate the efficacy of hyperbaric oxygenation during different periods on patients with acute embolic stroke. Methods Patients with acute embolic stroke admitted within 48 hours of onset from June 2004 to February 2006 with National Institutes of Health Stroke Scale （ NIHSS ） scores on admission of 5 or more were assigned randomly to HBO A, HBO B and control groups （ C ）. The HBOA group underwent HBO therapy combined with conventional treatment immediately. The HBO B group were treated conventionally firstly and underwent HBO therapy on the 15th day after onset. The control group received only conventional treatment. The primary endpoint was the modified Rankin Scale score at 90 days （favorable outcome, score 0 or 1 ）. The secondary endpoint was the NIHSS score at 5 days. Blood test was performed in three days of the clearest manifestations and then twenty-one days later, and SOD and MDA contents were determined. Results 11 of the 28 patients in the HBOA group,5 of the 28 patients in the HBO B group,and 2 of the 28 patients in the control group, had favorable outcomes at 90 days （ P 〈 0. 05 ）, although NIHSS score at 5 days did not differ significantly among the three groups. Plasma MDA in all the three groups was obviously decreased （P 〈 0. 05 ）, but those treated with HBO showed much more changes （P 〈 0. 05 ）, and the earlier the better. SOD content increased, and there was no significant difference among the three groups （ P 〉 0. 05 ）. Conclusions HBO therapy appeared to be effective in the treatment of patients with embolic stroke. It could decrease plasma MDA and the earlier the better.
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2007年第2期104-107,共4页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
