高压氧联合奥拉西坦对脑外伤后患者的认知功能及相关细胞因子的影响  

Effects of hyperbaric oxygen combined with Oxiracetam on cognitive function and related cytokines in patients after brain trauma

作　　者：王永楠[1] 殷杰[1] 汤畅通 Wang Yongnan;Yin Jie;Tang Changtong(Department of Neurosurgery,Xuzhou Central Hospital(The Xuzhou School of Clinical Medicine of Nanjing Medical University),Xuzhou 221000,China)

机构地区：[1]徐州市中心医院神经外科(南京医科大学徐州临床医学院)

出　　处：《中华神经创伤外科电子杂志》2019年第6期349-352,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：江苏省科技厅临床医学专项课题(BL2014028)

摘　　要：目的探讨高压氧联合奥拉西坦对外伤后认知障碍患者的认知功能及相关细胞因子的影响。方法选取徐州市中心医院神经外科自2017年1月至2018年10月住院治疗的脑外伤后认知障碍的患者60例,随机分为对照组和治疗组各30例,对照组给予传统的常规疗法治疗,治疗组在常规治疗的基础上给予高压氧联合奥拉西坦治疗,疗程3周。治疗前、治疗3周行血清血管形成素-1(Ang-1)、血管内皮生长因子(VEGF)和脑源性神经营养因子(BDNF)浓度测定,采用中文版蒙特利认知评分量表(MOCA)评估认知功能。结果2组患者治疗前的血清Ang-1、VEGF、BDNF水平比较,差异无统计学意义(P>0.05)。治疗3周后,2组患者的血清Ang-1、VEGF、BDNF水平均较治疗前增加,治疗组血清Ang-1、VEGF、BDNF水平较对照组增加明显,差异有统计学意义(P<0.05)。2组患者治疗前MOCA评分比较,差异无统计学意义(P>0.05)。治疗3周后,治疗组的MOCA评分较对照组高,差异具有统计学意义(P<0.05)。结论高压氧联合奥拉西坦治疗脑外伤后认知障碍患者较常规治疗可促进血清Ang-1、VEGF和BDNF的分泌,从而改善急脑外伤后认知障碍患者的认知功能。Objective To investigate the effect of hyperbaric oxygen combined with Oxiracetam on cognitive function and related cytokines in patients with post-traumatic cognitive impairment.Methods Sixty patients with post-traumatic cognitive impairment hospitalized from January 2017 to October 2018 in neurosurgery department of Xuzhou Central Hospital were randomly divided into control group and treatment group,30 cases in each group.The control group received conventional routine treatment,and the treatment group was treated with hyperbaric oxygen combined with Oxiracetam on the basis of routine treatment.The course of treatment is 3 weeks.The concentration of angiopoietin-1(Ang-1),brain-derived neurotrophic factor(BDNF)and vascular endothelial growth factor(VEGF)were measured,and the Chinese version of the Monterey’s cognitive-score scale(MOCA)was used to evaluate the cognitive functions before treatment and 3 weeks after treatment.Results Before treatment there was no significant difference in the levels of Ang-1,VEGF and BDNF between the two groups(P>0.05).After 3 weeks of treatment,the serum levels of Ang-1,VEGF and BDNF in the two groups increased.The levels of serum Ang-1,VEGF and BDNF in the treatment group were significantly higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in MOCA score between the two groups before treatment(P>0.05).After 3 weeks of treatment,the MOCA score of the treatment group was higher than that of the control group(P<0.05),and the difference was statistically significant.Conclusion Compared with conventional therapy,hyperbaric oxygen combined with oxiracetam can promote the secretion of Ang-1,VEGF and BDNF in patients with post-traumatic cognitive impairment,thus improving the cognitive function of patients with post-traumatic cognitive impairment.

关 键 词：脑外伤后认知障碍 血管形成素-1 血管内皮生长因子 脑源性神经营养因子 高压氧 奥拉西坦 

分 类 号：R74[医药卫生—神经病学与精神病学]