不同频次高压氧治疗对脑卒中早期患者神经功能和肠黏膜屏障功能及血清CIT IFABP ITF的影响  

Effect of different frequency of hyperbaric oxygen therapy on neurological function,intestinal mucosal barrier function and serum CIT,IFABP and ITF in early stroke patients

作　　者：王震 冯慧 付娟娟 周修五 潘化平 WANG Zhen;FENG Hui;FU Juanjuan;ZHOU Xiuwu;PAN Huaping(Jiangning Hospital Affiliated to Nanjing Medical University,Nanjing 210001,China)

机构地区：[1]南京医科大学附属江宁医院,江苏南京210001

出　　处：《中国实用神经疾病杂志》2024年第3期356-360,共5页Chinese Journal of Practical Nervous Diseases

基　　金：江苏省南京医科大学科技发展基金项目(编号:NMUB2020161);江苏省科技项目(编号:BE2021618)。

摘　　要：目的探究不同频次高压氧治疗对脑卒中早期患者神经功能、肠黏膜屏障功能及血清瓜氨酸(CIT)、肠型脂肪酸结合蛋白(IFABP)、肠三叶因子(ITF)的影响。方法将南京医科大学附属江宁医院收治的89例脑卒中患者随机分为对照组(29例,行常规药物治疗)、低频次组(30例,在对照组基础上给予低频高压氧治疗)、高频次组(30例,在对照组基础上给予高频高压氧治疗)。治疗前及治疗结束后4周评估3组患者神经功能、日常生活活动能力,同时检测3组患者肠黏膜屏障功能指标及血清CIT、IFABP、ITF水平,观察3组患者不良反应情况。结果治疗结束后4周,对照组、低频次组和高频次组患者NIHSS评分、内毒素(ET)、二胺氧化酶(DAO)、D-乳酸、IFABP、ITF水平均低于治疗前(P<0.05),MBI评分、CIT水平均高于治疗前(P<0.05)。与对照组相比,低频次组和高频次组患者NIHSS评分[分别为(6.23±2.05)分、(4.52±1.87)分]、ET[分别为(0.31±0.06)IU/mL、(0.21±0.05)IU/mL]、DAO[分别为(2.64±0.31)IU/mL、(1.71±0.18)IU/mL]、D-乳酸[分别为(0.16±0.04)mmol/L、(0.10±0.02)mmol/L]、IFABP[分别为(0.89±0.13)μg/L、(0.52±0.08)μg/L]、ITF[分别为(9.02±2.14)μg/L、(7.36±1.75)μg/L]水平更低(P<0.05),MBI评分[分别为(84.02±7.51)分、(90.89±5.42)分]、CIT[分别为(24.45±3.02)μmol/L、(31.42±3.31)μmol/L]水平更高(P<0.05)。与低频次组相比,高频次组患者NIHSS评分更低(P<0.05),MBI评分、CIT水平更高(P<0.05)。3组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论早期对脑卒中患者实施高压氧治疗可明显改善患者神经功能、肠道黏膜屏障功能及胃肠功能,提高患者生活活动能力,安全性好,高频次高压氧的治疗效果更好。Objective To investigate the effect of different frequencyies of hyperbaric oxygen therapy on nerve function,intestinal mucosal barrier function,serum citrulline(CIT),intestinal fatty acid-binding protein(IFABP)and intestinal trefoil factor(ITF)in early stroke patients.Methods Eighty-nine stroke patients admitted to Jiangning Hospital Affiliated to Nanjing Medical University were randomly divided into control group(29 cases,receiving conventional drug treatment),low-frequency group(30 cases,receiving low-frequency hyperbaric oxygen therapy on the basis of the control group),and high-frequency group(30 cases,receiving high-frequency hyperbaric oxygen therapy on the basis of the control group).Neurological function and activities of daily living in the three groups were assessed before treatment and 4 weeks after treatment,intestinal mucosal barrier function indexes and serum levels of CIT,IFABP and ITF were detected in the three groups at the same time,and adverse reactions were observed in the three groups.Results After 4 weeks of treatment,NIHSS score,endotoxin(ET),diamine oxidase(DAO),D-lactic acid,IFABP and ITF levels in control group,low frequency group and high frequency group were lower than before treatment(P<0.05),and the MBI score and CIT level were higher than before treatment(P<0.05).Compared to the control group,NIHSS scores((6.23±2.05)points,(4.52±1.87)points,respectively),ET((0.31±0.06)IU/mL,(0.21±0.05)IU/mL,respectively),DAO((2.64±0.31)IU/mL,(1.71±0.18)IU/mL,respectively)of patients in low frequency group and high frequency group,D-lactic acid((0.16±0.04)mmol/L,(0.10±0.02)mmol/L,respectively),IFABP((0.89±0.13)μg/L,(0.52±0.08)μg/L,respectively),ITF((9.02±2.14)μg/L,(7.36±1.75)μg/L,respectively)were lower(P<0.05),and the MBI score((84.02±7.51)points,(90.89±5.42)points,respectively)and CIT((24.45±3.02)μmol/L,(31.42±3.31)μmol/L,respectively)were higher(P<0.05).Compared with the low frequency group,the NIHSS score of the high frequency group was lower(P<0.05),and the MBI score and C

关 键 词：脑卒中 高压氧 高频次 低频次 神经功能 肠黏膜屏障 瓜氨酸 肠型脂肪酸结合蛋白 肠三叶因子 血清 

分 类 号：R743.3[医药卫生—神经病学与精神病学]