高压氧治疗对脑损伤意识障碍患者血清hs-CRP和NSE水平的影响及临床意义  

Effect and clinical significance of hyperbaric oxygen therapy on serum hs-CRP and NSE levels in patients with consciousness disorder due to brain injury

作　　者：董文硕 杨晶[2] 李雅娟[1] Dong Wenshuo;Yang Jing;Li Yajuan(Department of Hyperbaric Oxygen,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;Department of Hyperbaric Oxygen,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京潞河医院高压氧科,北京101149 [2]首都医科大学附属北京朝阳医院高压氧科,北京100020

出　　处：《中华航海医学与高气压医学杂志》2025年第1期6-9,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧(HBO)治疗对脑损伤意识障碍患者血清超敏C反应蛋白(hs-CRP)和神经元特异性烯醇化酶(NSE)水平的影响及临床意义。方法2018年选取首都医科大学附属北京朝阳医院收治的脑损伤意识障碍患者作为脑损伤组(n=27),另取健康体检者作为对照组(n=10)。对照组不予以任何治疗,脑损伤组患者在常规药物治疗的基础上应用HBO治疗。采用酶联免疫吸附法检测脑损伤组患者HBO治疗前后及对照组健康体检者的血清hs-CRP和NSE水平;在HBO治疗前后分别采用格拉斯哥昏迷量表(GCS)以及改良昏迷恢复量表(CRS-R)评估脑损伤组患者的脑损伤及意识改善情况;通过斯皮尔曼等级相关分析以及受试者操作特征(ROC)曲线评价脑损伤组患者血清hs-CRP、NSE水平与意识状态的关系及临床意义。结果HBO治疗前后脑损伤组患者血清hs-CRP水平[(10.93±4.47)mg/L、(6.08±4.24)mg/L]均明显高于对照组[(1.08±0.67)mg/L],HBO治疗前血清NSE水平[(21.90±7.75)ng/L]明显高于对照组[(15.5±3.45)ng/L],差异均有统计学意义(均P<0.05)。HBO治疗后脑损伤组患者血清hs-CRP、NSE水平均明显降低,GCS、CRS-R评分均明显增加,差异均有统计学意义(均P<0.05)。血清hs-CRP和NSE水平与GCS分级呈正相关性(r=0.390),与GCS、CRS-R评分呈负相关性(r=-0.458,-0.519),差异均有统计学意义(均P<0.05)。ROC曲线分析结果显示,NSE对脑损伤意识障碍的评价效能优于hs-CRP,差异有统计学意义(P<0.05)。结论血清hs-CRP和NSE水平反映脑损伤患者意识障碍严重程度,HBO治疗可通过降低血清hs-CRP和NSE水平改善脑损伤意识障碍患者的意识水平,有利于患者预后。Objective To investigate the effect and clinical significance of hyperbaric oxygen(HBO)therapy on serum levels of hyper-sensitive C-reactive protein(hs-CRP)and neuron-specific enolase(NSE)in patients with consciousness disorder due to brain injury.Methods The patients with consciousness disorder due to brain injury admitted to Beijing Chaoyang Hospital affiliated to Capital Medical University in 2018 were selected into a brain injury group(n=27),and healthy subjects who attended physical examination were selected into a control group(n=10),without any treatment.The patients with brain injury were treated with HBO on the basis of conventional drug therapy.In the brain injury group and the control group,the levels of serum hs-CRP and NSE were detected by enzyme-linked immunosorbent assay(ELISA)before and after 20 times of HBO therapy.Glasgow coma scale(GCS)and coma recovery scale revised(CRS-R)were used to evaluate the brain injury and consciousness improvement of patients before and after HBO treatment.Spearman’s rank-order correlation analysis and receiver operating characteristic(ROC)curve were employed to evaluate the relationship between serum hs-CRP and NSE levels and the state of consciousness in patients with consciousness disorder due to brain injury.Results The serum levels of hs-CRP in the brain injury group before and after HBO treatment[(10.93±4.47)mg/L,(6.08±4.24)mg/L]were significantly higher than those in the control group[(1.08±0.67)mg/L].The serum NSE level before HBO treatment[(21.90±7.75)ng/L]was significantly higher than that in the control group[(15.5±3.45)ng/L],and the differences were statistically significant(all P<0.05).After HBO treatment,the levels of hs-CRP and NSE in the brain injury group were significantly decreased,and the scores of GCS and CRS-R were significantly increased,with statistically significant differences(all P<0.05).Serum hs-CRP and NSE levels were positively correlated with GCS grade(r=0.390),and negatively correlated with GCS and CRS-R scores(r=-0.458,-0.519),a

关 键 词：脑损伤 意识障碍 高压氧 超敏C反应蛋白 神经元特异性烯醇化酶 

分 类 号：R651.15[医药卫生—外科学]