高压氧联合重复经颅磁刺激技术对脑卒中后抑郁患者血清细胞因子及神经递质的影响  

Effects of hyperbaric oxygen combined with repetitive transcranial magnetic stimulation on serum cytokines and neurotransmitters in patients with post-stroke depression

作　　者：金可卓 缪荣明 范春建 吴铭柯 刘跃 王洁 JIN Ke-zhuo;MIAO Rong-ming;FAN Chun-jian;WU Ming-ke;LIU Yue;WANG Jie

机构地区：[1]江阴博医家康复医院,江苏江阴214411

出　　处：《中国疗养医学》2025年第5期23-26,共4页Chinese Journal of Convalescent Medicine

基　　金：无锡市卫生健康委员会科技发展项目(Q202251)。

摘　　要：目的探讨高压氧(HBO)联合重复经颅磁刺激(rTMS)技术对脑卒中后抑郁(PSD)患者细胞因子和神经递质的影响。方法选取2022年1月至2023年12月江阴博医家康复医院46例PSD患者作为研究对象。通过随机数字表划分为对照组与研究组,每组各23例。两组均予脑卒中常规治疗,口服艾司西酞普兰10 mg,1次/d。高压氧方案:间断面罩吸纯氧1 h,之后改成呼吸舱内空气,20 min后便可出舱,1次/d,10次为1个疗程,每个疗程有3~5 d间隔期,治疗4个疗程。研究组在上述治疗基础上联合rTMS治疗,20 min/次,1次/d,5次/周,10次为1个疗程,治疗前后检测两组血清神经递质水平及细胞因子水平变化。结果入院时,两组血清氨基酸类神经递质、炎症因子水平差异无统计学意义(P>0.05)。治疗4个疗程后,研究组血清神经递质谷氨酸(GLu)(12.17±1.31)mg/dL水平显著低于对照组(18.28±2.31)mg/dL,差异有统计学意义(P<0.05),甘氨酸(GLy)(2.86±0.43)mg/dL水平显著高于对照组(2.19±0.24)mg/dL,差异有统计学意义(P<0.05);血清炎性因子肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、白介素-6(IL-6)水平均显著低于对照组(P<0.05)。结论对PSD患者在脑卒中常规治疗及抗抑郁剂治疗的同时,联合HBO与rTMS治疗具有协同增效作用,能有效调节神经递质平衡,降低炎性因子水平,改善或缓解抑郁症状,有利于促进患者神经功能的康复。Objective To investigate the effects of hyperbaric oxygen(HBO)combined with repetitive transcranial magnetic stimulation(rTMS)on cytokines and neurotransmitters in patients with post-stroke depression(PSD).Methods A total of 46 patients with PSD in Jiangyin Boyijia Rehabilitation Hospital from January 2022 to December 2023 were selected as the study objects.The patients were randomly divided into control group and study group with 23 cases in each group.Both groups received conventional treatment of stroke,escitalopram 10 mg orally,once a day.Hyperbaric oxygen program:intermittent mask inhalation of pure oxygen for 1 h,then changed to breathing cabin air,20 minutes later came out of the cabin,once/day,10 times for a course of treatment,each course had an interval of 3 to 5 days,treatment of 4 courses.On the basis of the above treatment,the study group combined with rTMS treatment,20 min/time,once/day,5 times/week,10 times as a course of treatment.The changes of serum neurotransmitter and cytokine levels in the two groups were detected before and after treatment.Results At admission,there was no difference of statistical significance in the levels of serum amino acid neurotransmitters and inflammatory factors between the two groups(P>0.05).After 4 courses of treatment,the level of serum neurotransmitter glutamic acid(GLu)(12.17±1.31)mg/dL in the study group was significantly lower than that in the control group(18.28±2.31)mg/dL,and the difference was statistically significant(P<0.05).The level of glycine(GLy)(2.86±0.43)mg/dL was significantly higher than that in the control group(2.19±0.24)mg/dL and the difference was statistically significant(P<0.05).Serum levels of inflammatory factor tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and interleukin-6(IL-6)were significantly lower than those of control group(P<0.05).Conclusion In addition to the conventional treatment of stroke and antidepressant treatment for PSD patients,the combination of HBO and rTMS therapy has a synergistic effect,which can effective

关 键 词：脑卒中后抑郁 重复经颅磁刺激 艾司西酞普兰 神经递质 炎性因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]