高压氧对急性缺血性脑卒中患者血清TNF-α、ET及NPY的影响  

Effect of hyperbaric oxygenation on serum TNF-α,endothelin and neuropeptide Y in patients with acute ischemic stroke

作　　者：赵波 张斌 ZHAO Bo;ZHANG Bin(Department of Neurology, Anning Branch of Lanzhou General Hospital of PLA, Lanzhou 730070, China;Lanzhou General Hospital of PLA;Hong Kong Garrison Hospital of PLA)

机构地区：[1]解放军兰州总医院安宁分院神经内科,甘肃兰州730070 [2]解放军兰州总医院 [3]解放军驻香港部队医院

出　　处：《西北国防医学杂志》2018年第6期370-374,共5页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省自然科学基金项目(17JR5RA328)

摘　　要：目的:探讨高压氧对急性缺血性脑卒中患者血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、内皮素(endothelin,ET)及神经肽Y(neuropeptide Y,NPY)的影响。方法:选择80例急性缺血性脑卒中患者,随机分为高压氧治疗组和常规治疗组,每组40例;另选健康体检者40例为健康对照组。高压氧治疗组在常规治疗的基础上应用高压氧疗法,在发病后不同时间点(第1、7、14、28天)分别测定血清TNF-α、ET及NPY含量;并在发病后第1天及第90天分别进行神经功能缺损评分。结果:发病后第1天高压氧治疗组及常规治疗组血清TNF-α、ET及NPY水平均明显高于健康对照组,差异均有统计学意义(P<0.05)。发病第1、7、14天时高压氧治疗组患者血清TNF-α、ET及NPY含量与常规治疗组比较,差异无统计学意义(P>0.05)。发病第28天时高压氧治疗组患者血清TNF-α、ET及NPY水平明显降低,且低于常规治疗组,差异均有统计学意义(P<0.05)。发病后第1天高压氧治疗组患者美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分与常规治疗组比较,差异无统计学意义(P>0.05);发病后第90天高压氧治疗组患者NIHSS评分显著低于常规治疗组,差异有统计学意义(P<0.05)。结论:高压氧可以降低急性缺血性脑卒中患者血清TNF-α、ET及NPY水平,减轻脑梗死后脑组织炎性反应,从而有效改善急性脑梗死患者预后。Objective：To investigate the effect of hyperbaric oxygenation on serum tumor necrosis factor-α（TNF-α）,endothelin（ET）and neuropeptide Y（NPY）in patients with acute ischemic stroke.Methods：Eighty patients with acute ischemic stroke were randomly divided into hyperbaric oxygenation therapeutic group and conventional therapy group,40 cases in each group,and forty healthy people were selected as healthy control group.Hyperbaric oxygenation therapeutic group was given hyperbaric oxygenation basis on the conventional therapy.The level of serum TNF-α,ET and NPY in the two groups were monitored in different point of time（at days 1,7,14 and 28）by radioimmunoassay.National institute of health stroke scale（NIHSS）evaluation were compared at day 1 and day 90.Results：The levels of TNF-α,ET and NPY in serum were increased significantly in hyperbaric oxygenation therapeutic group and conventional therapy group at days 1,which were higher than those of healthy control group（P〈0.05）.There were no significant differences in levels of TNF-α,ET and NPY between hyperbaric oxygenation therapeutic group and conventional therapy group at day 1,7 and day 14（P〉0.05）.The levels of TNF-α,ET and NPY in serum were decreased significantly in hyperbaric oxygenation therapeutic group at day 28,which were lower than those of conventional therapy group（P〈0.05）.There was no significant difference in NIHSS score at day 1 between hyperbaric oxygenation therapeutic group and conventional therapy group.But NIHSS score of hyperbaric oxygenation therapeutic group was significantly lower than that in conventional therapy group at day 90（P〉0.05）.Conclusion：Hyperbaric oxygenation can decreases the levels of serum TNF-α,ET and NPY and improve NIHSS score of patients with acute ischemic stroke.It suggests that hyperbaric oxygenation can protect secondary brain injury partially and improve prognosis of patients with acute ischemic stroke.

关 键 词：急性缺血性脑卒中 神经肽Y 内皮素 血清肿瘤坏死因子 高压氧 

分 类 号：R743[医药卫生—神经病学与精神病学]