高压氧对高血压脑出血微创术后NPY、NT的影响  

Effects of hyperbaric oxygen on neuropeptide Y and neurotensin for patients with hypertensive intracerebral hemorrhage after minimally invasive surgery

作　　者：姚向荣 冯海霞[2] 万东君 王向红 王继芳 苟丽红 YAO Xiangrong;FENG Haixia;WAN Dongjun;WANG Xianghong;WANG Jifang;GOU Lihong(Department of Rehabilitation,the 940th Hospital of Joint Logistic Support Force,Chinese People’s Liberation Army,Lanzhou 730030,Gansu,China;Department of Neurology,Gansu Province Hospital Rehabilitation Center,Lanzhou 730000,Gansu,China;Department of Neurology,the 940th Hospital of Joint Logistic Support Force,PLA,Lanzhou 730030,Gansu,China;Department of Comprehensive surgical,the 940th Hospital of Joint Logistic Support Force,PLA,Lanzhou 730030,Gansu,China)

机构地区：[1]解放军联勤保障部队第九四〇医院康复医学科,甘肃兰州730030 [2]甘肃省康复中心医院神经内科,甘肃兰州730000 [3]解放军联勤保障部队第九四〇医院神经内科,甘肃兰州730030 [4]解放军联勤保障部队第九四〇医院综合外科,甘肃兰州730030

出　　处：《中国现代医生》2023年第26期56-60,共5页China Modern Doctor

基　　金：兰州市人才创新创业项目(2019-RC-40)。

摘　　要：目的探讨高血压脑出血(hypertensive intracerebral hemorrhage,HICH)微创术后患者早期高压氧(hyperbaric oxygenation,HBO)治疗对血浆神经肽Y(neuropeptide Y,NPY)、神经降压素(neurotensin,NT)的影响。方法选取2019年1月至2021年12月解放军联勤保障部队第九四〇医院收治的HICH经微创血肿清除术后5d患者172例,采用随机数字表法分为研究组(n=86)和对照组(n=86),另同期选取86例进行体检健康者为正常组。对照组给予常规治疗及康复训练,研究组在对照组的基础上给予HBO治疗。测定治疗前和治疗后10d、22d、34d各组的NPY和NT水平。治疗前和治疗后34d、90d、180d时,采用美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)、简易智能精神状态检查量表(mini-mental state examination,MMSE)、运动功能评估量表(Fugl-Meyer assessment,FMA)、日常生活活动能力表(Barthel index,BI)对研究组和对照组进行评估。结果治疗前,研究组与对照组NPY、NT水平比较,差异无统计学意义(P>0.05)。治疗后10d,22d及34d,研究组NPY、NT水平均显著低于对照组(P<0.05)。研究组治疗前、治疗后10~22d及对照组治疗前、治疗后10~34d NPY和NT水平均显著高于正常值(P<0.05),两组NPY和NT水平逐渐下降,研究组34d基本恢复正常,两组比较差异无统计学意义(P>0.05)。治疗前,研究组与对照组NIHSS、MMSE、Fugl-Meyer、BI评分比较,差异无统计学意义(P>0.05)。治疗后34d,90d及180d,研究组NIHSS评分均显著低于对照组(P<0.05)。治疗后34d,90d及180d,研究组MMSE、Fugl-Meyer、BI评分均显著高于对照组(P<0.05)。结论HICH微创术后早期HBO治疗显著降低血浆NPY及NT水平,有利于患者神经功能、认知功能、躯体运动功能和日常生活能力恢复,值得临床普及应用。Objective To investigate the effects of early hyperbaric oxygen(HBO)therapy on plasma neuropeptide Y(NPY)and neurotensin(NT)in patients with hypertensive intracerebral hemorrhage(HICH)after minimally invasive surgery.Methods A total of 172 patients admitted to HICH for 5 days after minimally invasive hematoma removal from January 2019 to December 2021 were selected and randomly divided into study group and control group,according to the order of admission,86 cases in each group.Another 86 cases of healthy people who underwent physical examination were selected as the normal group in the same period.Both groups were given routine treatment and rehabilitation training,and the study group was given HBO for 10 days as a course of treatment,each course interval of 2 days,a total of 3 courses.Plasma levels of NPY and NT were detected before treatment and after treatment at 10,22 and 34 days respective.The United States National Institutes of Health stroke scale(NIHSS),mini-mental state examination(MMSE),Fugl-Meyer assessment(FMA)and Barthel index(BI)were used to evaluate the patients before treatment and on days 34,90,180 after treatment.Results There were no significant differences in NPY and NT levels between the study groups and control groups before treatment(P>0.05).However,on days 10,22 and 34 after treatment,the study group had significantly lower NPY and NT levels compared to the control group(P<0.05).Compared with the normal values of NPY and NT,study group were significantly increased during before treatment and after treatment day 10-22 and control group during before treatment and after treatment days 10-34 respectively(P<0.05).Both NPY and NT levels gradually decreased over time,and the study group’s NPY and NT levels returned to near-normal levels on days 34(P>0.05).Before treatment,there were no significant differences in NIHSS,MMSE,Fugl-Meyer,and BI scores between the study and control groups(P>0.05).However,on days 34,90,and 180 after treatment,the study group had significantly lower NIHSS scores com

关 键 词：高血压脑出血 高压氧 微创手术 康复治疗 神经肽Y 神经降压素 

分 类 号：R743[医药卫生—神经病学与精神病学]