摘要
目的 探讨不同治疗时间窗高压氧治疗对急性脑梗死(ACI)患者颈动脉血流动力学及血清同型半胱氨酸(Hcy)、可溶性细胞间黏附分子-1 (sICAM-1)、白细胞介素-1β (IL-1β)水平的影响。方法 选取2022年10月至2023年12月昆明医科大学第一附属医院神经内科收治的180例ACI患者,根据随机数字表法分为4组,各45例。对照组不接受高压氧治疗,早期组在发病72h内接受高压氧治疗,中期组在发病3~7d内接受高压氧治疗,晚期组在发病7d后接受高压氧治疗。对比各组临床疗效、颈动脉血流动力学状况及血清Hcy、sICAM-1、IL-1 β水平变化。结果 治疗后,早期组总有效率显著高于中期组、晚期组及对照组(^(均)P<0.05)。治疗后,早期组美国国立卫生院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分均低于中期组、晚期组及对照组,中期组低于晚期组及对照组(^(均)P<0.05);早期组治疗后颈动脉平均血流速(Vm)、搏动指数(PI)、阻力指数(RI)优于中期组、晚期组和对照组,中期组颈动脉Vm、PI、RI又优于晚期组和对照组(^(均)P<0.05);早期组治疗后血清Hcy、sICAM-1及IL-1 β水平低于中期组、晚期组和对照组,中期组血清Hey、sICAM-1及IL-1 β水平又低于晚期组和对照组(^(均)P <0.05)。结论 ACI患者在发病72 h内接受高压氧治疗效果显著,可有效改善颈动脉血流状况,降低血管损害和炎症反应程度,具有较高安全性。
Objective To investigate the effects of hyperbaric oxygen therapy with different time windows on carotid hemodynamics and serum homocysteine(Hey),soluble intercellular adhesion molecule-1(sICAM-1)and interleukin-1β(IL-1β)levels in patients with acute cerebral infarction(ACI).Methods 180 patients with ACI admitted to the first affiliated hospital of Kunming medical university from October 2022 to December 2023 were selected and divided into 4 groups with 45 cases each according to random number table method.The control group did not receive hyperbaric oxygen therapy,the early group received hyperbaric oxygen therapy within 72 hours of onset,the middle group received hyperbaric oxygen therapy within 3 to 7 days of onset,and the late group received hyperbaric oxygen therapy 7 days after onset.The clinical effect,carotid hemodynamics and serum levels of Hey,sICAM-1 and IL-1β were compared among all groups.Results After treatment,the total effective rate of early group was significantly higher than that of middle group,late group and control group(P<0.05).After treatment,NIHSS score and mRS Score in early group were lower than those in middle group,late group and control group,and middle group was lower than those in late group and control group(allP<0.05).The mean carotid blood flow velocity(Vm),pulsation index(PI)and resistance index(RI)in early group were better than those in middle group,late group and control group,and the carotid Vm,PI and RI in middle group were better than those in late group and control group(^(all) P<0.05).After treatment,serum Hey,sICAM-1 and IL-1 β levels in early group were lower than those in middle group,late group and control group,and serum Hey,sICAM-1 and IL-1 β levels in middle group were lower than those in late group and control group(^(all) P<0.05).Conclusion Hyperbaric oxygen therapy in ACI patients within 72 hours of onset has a significant effect,which can effectively improve carotid blood flow,reduce vascular damage and inflammation,and has a high safety.
作者
韩娟
钟莲梅
雷春艳
康丽香
Han Juan;Zhong Lianmei;Lei Chunyan;Kang Lixiang(The First Affiliated Hospital of Kunming Medical University,Yunnan 650031,China)
出处
《脑与神经疾病杂志》
CAS
2024年第9期576-580,共5页
Journal of Brain and Nervous Diseases
基金
云南省卫生健康委临床医学中心建设项目(ZX2019-03-05)
云南省神经系统疾病诊疗中心应用基础研究专项基金子项目(ZX2022-09-01)。
