高压氧联合长春胺对脑梗死恢复期患者脑血流量、脑能量代谢及血栓前状态指标的影响  

The Effects of Hyperbaric Oxygen Combined with Vincamine on Cerebral Blood Flow,Cerebral Energy Metabolism and Indicators of Prethrombotic State in Patients Recovering from Cerebral Infarction

作　　者：张鹏[1] 王斌[2] 吴惠霞 ZHANG Peng;WANG Bin;WU Huixia(Department of Hyperbaric Oxygen Chamber Therapy,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng,Shanxi 044000,China;Department of Neurology,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng,Shanxi 044000,China)

机构地区：[1]山西医科大学附属运城市中心医院高压氧舱治疗室,山西运城044000 [2]山西医科大学附属运城市中心医院神经内科,山西运城044000

出　　处：《转化医学杂志》2024年第9期1449-1453,共5页Translational Medicine Journal

摘　　要：目的观察高压氧联合长春胺对脑梗死恢复期患者脑血流量、脑能量代谢及血栓前状态指标的影响。方法选取2021年8月至2024年2月运城市中心医院收治的124例脑梗死恢复期患者,采用随机数字法分为长春胺缓释胶囊组(对照组)与高压氧联合长春胺缓释胶囊组(观察组),每组62例。所有患者均接受常规药物和康复治疗,对照组另采用长春胺缓释胶囊治疗,观察组另采用高压氧联合长春胺缓释胶囊治疗。分别比较长春胺缓释胶囊组(对照组)与高压氧联合长春胺缓释胶囊组(观察组)组治疗前后美国国立卫生研究院卒中量表(NIHSS)、脑血流量、脑能量代谢、血栓前状态指标、改良Barthel指数(MBI)、神经元特异性烯醇化酶(NSE)、神经营养因子3(NT-3)水平差异。结果与治疗前比较,治疗后2组NIHSS评分降低,且观察组更低(P<0.05);治疗后2组MBI评分升高,且观察组更高(P<0.05);与治疗前比较,治疗后2组空腹血糖、乳酸降低,且观察组更低(P<0.05);治疗后2组血氧饱和度升高,且观察组更高(P<0.05);观察组脑能量代谢治疗前后差值较对照组更大(P<0.05);与治疗前比较,治疗后2组脑血特性阻抗(ZCV)、脑血管外周阻力(R)降低,且观察组更低(P<0.05);治疗后2组脑血管平均血流速度(Vmean)、平均血流量(Qmean)升高,且观察组更高(P<0.05);观察组脑血流量治疗前后差值较对照组更大(P<0.05)与治疗前比较,治疗后2组NSE降低,且观察组更低(P<0.05);治疗后2组NT-3升高,且观察组更高(P<0.05);与治疗前比较,治疗后2组FIB、D-D、PAC-1、MAR降低,且观察组更低(P<0.05)。结论高压氧联合长春胺治疗脑梗死恢复期可改善患者脑血流量、脑能量代谢,纠正血栓前状态,减轻神经缺损程度。Objective To observe the effects of hyperbaric oxygen combined with Vincamine on cerebral blood flow,cerebral energy metabolism and indicators of prethrombotic state in patients with cerebral infarction in the recovery period.Methods 124 patients with cerebral infarction in the recovery period,who were admitted to our hospital from August 2021 to February 2024,were selected and divided into two groups using random numbers method,with 62 cases in each group.The control group was treated with Vincamine extended-release capsules,and the observation group was treated with hyperbaric oxygen combined with Vincamine extended-release capsules.The differences in the levels of National Institutes of Health Stroke Scale(NIHSS),cerebral blood flow,cerebral energy metabolism,pre-thrombotic state index,modified Barthel index(MBI),neuron-specific enolase(NSE),and neurotrophic factor 3(NT-3)were compared before and after the treatment of the two groups,respectively.Results Compared with before treatment,the NIHSS scores in both groups decreased after treatment,and the observation group had significantly lower scores(P<0.05).After treatment,the MBI scores of both groups increased,and the observation group had a higher score(P<0.05).Compared with before treatment,the fasting blood glucose and lactate levels in both groups decreased after treatment,and the observation group had lower levels(P<0.05).After treatment,both groups showed an increase in blood oxygen saturation,with the observation group having a higher level(P<0.05).The difference in brain energy metabolism before and after treatment in the observation group was greater than that in the control group(P<0.05).Compared with before treatment,ZCV and R decreased in both groups after treatment,and the observation group had even lower values(P<0.05).After treatment,Vmean and Qmean increased in both groups,and the observation group had even higher values(P<0.05).The difference in cerebral blood flow before and after treatment in the observation group was greater than that in th

关 键 词：高压氧 长春胺缓释胶囊 脑梗死恢复期 血栓前状态 脑能量代谢 脑血流量 

分 类 号：R743.32[医药卫生—神经病学与精神病学]