高压氧治疗急性脑梗死的疗效以及对患者血清血管内皮生长因子、促血管生成素Ⅱ的影响

Clinical effect of hyperbaric oxygenation on acute cerebral infarction and its influence on serum content of VEGF and Ang-2

摘要:

目的  观察高压氧治疗对急性脑梗死的临床疗效及其血清中血管内皮生长因子（VEGF）、促血管生成素Ⅱ（Ang-2）含量的影响。方法  选取200例急性脑梗死患者随机分为高压氧治疗组（治疗组）114例、非高压氧治疗组（对照组）86例，两组患者均进行30 d治疗。分别比较两组治疗前后神经功能缺损（NIHSS）评分，日常生活活动能力（ADL）评分及血清中Ang-2、VEGF水平的变化。结果  治疗后两组患者临床神经功能缺损程度评分均有所减少，与治疗前比较，两组均在治疗后24 h内评分差异有统计学意义（P <0.05），治疗组较对照组评分显著减少，且随着时间延长，评分呈时间依赖性降低；治疗后两组患者ADL评分均有所提高，与治疗前比较，两组在治疗后24 h评分差异无统计学意义（P >0.05），治疗15 d后评分差异有统计学意义（P <0.05），治疗组较对照组评分显著增高，且随着时间延长，评分呈时间依赖性升高；两组治疗后血清VEGF及Ang-2含量的比治疗前患者血清中VEGF及Ang-2含量均有不同程度增加，治疗组较对照组VEGF及Ang-2含量显著增加，VEGF及Ang-2含量15 d时达到高峰，30 d时有所下降，与治疗前比较，两组在治疗后24 h VEGF及Ang-2含量差异无统计学意义（P >0.05）。治疗15 d后及30 d后VEGF及Ang-2含量差异有统计学意义（P <0.05）。结论  高压氧治疗可调节脑梗死患者血清中Ang-2 、VEGF的含量，改善神经功能缺损及提高日常生活活动能力，值得进一步研究及应用。

Abstract:

Objective To observe the clinical efficacy of hyperbaric oxygenation on patients with acute cerebral infarction and its effect on the serum content of VEGF and Ang-1． Methods Totally 200 acute cerebral infarction patients were divided into hyperbaric oxygenation treatment group (treatment group, 114 cases) and control group (86 cases). The course of treatment was 30 days. Degree of nervous functional defects (NIHSS) scores, activities of daily life abilities (ALD) scores and serum levels of Ang-2 and VEGF in the two groups were compared before and after treatment. Results The NIHSS scores of the two groups were obviously reduced after treatment. The scores after 24-h treatment were significantly different from those before treatment in both groups (P < 0.05), the improvements were more significant in the treatment group compared to those in the control group. The scores was time-dependently lowered. The ADL scores of both groups were obviously improved after treatment, the scores after 24-h treatment were not significantly different (P > 0.05) while the scores after 15-day treatment were significantly different (P < 0.05) from those before treatment in the two groups, the improvements were more significant in the treatment group than those in the control group. The scores was time-dependently increased. The serum levels of VEGF and Ang-2 were increased after treatment in both groups, the levels were significantly higher in the treatment group than in the control group (P < 0.05). The VEGF and Ang-2 levels peaked after 15-day treatment and declined on the 30th day of treatment. In both groups VEGF and Ang-2 levels after 24-h treatment had no significant difference from those before treatment (P > 0.05), the levels after 15-day treatment were significantly different from those after 30-day treatment (P < 0.05). Conclusions Hyperbaric oxygenation can regulate serum levels of Ang-2 and VEGF in patients with acute cerebral infarction and improve the degree of nervous functional defects and activities of daily life, therefore deserves further research and application．