万真,王金鑫,臧奎,薛青
WAN Zhen,WANG Jinxin,ZANG Kui,XUE Qing

• 1:南京医科大学附属淮安第一医院高压氧科
• 2:南京医科大学附属淮安第一医院重症医学科

摘要(Abstract)：

目的:探讨高压氧联合神经节苷脂对高血压脑出血患者脑血管功能的影响。方法:90例高血压脑出血患者随机均分为实验组与对照组,2组患者入院后均给予常规治疗,同时增加神经节苷脂连续治疗28 d,实验组在患者病情稳定7 d后给予高压氧连续治疗20 d;于治疗前及治疗结束时,采用头颅CT检测2组患者脑水肿面积,采用全自动血凝分析仪检测血液凝血酶水平,采用ELISA法检测血清髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)及S-100蛋白水平;采用脑血管功能分析仪检测患者脑血管平均流速(Vmean)、脑血管平均流量(Qmean)、动态阻力(DR)及外周血流阻力(R);采用Scandinavian脑卒中量表(SSS)及美国国立卫生研究院卒中量表(NIHSS)评价患者神经功能。结果:治疗前,2组患者脑水肿面积,MBP、凝血酶、NSE及S-100蛋白水平, Vmean、Qmean、DR及R值,SSS及NIHSS评分比较,差异无统计学意义(P>0.05);治疗结束时,2组患者脑水肿面积较治疗前缩小,实验组缩小更显著(P<0.01),2组患者血MBP、凝血酶、NSE及S-100蛋白水平、DR及R、NIHSS评分均较治疗前降低,实验组降低更显著,差异有统计学意义(P<0.05或P<0.01);2组患者Vmean及Qmean、SSS评分较治疗前升高,实验组升高更显著,差异有统计学意义(P<0.01)。结论:高压氧联合神经节苷脂治疗可以明显缩小高血压脑出血患者脑水肿面积,有效降低患者神经功能受损程度,改善脑血管功能。
Objective: To investigate the intervention effect of hyperbaric oxygen combined with gangliosides on cerebral vascular function in patients with hypertensive intracerebral hemorrhage. Methods: 90 patients with hypertensive intracerebral hemorrhage were selected and randomly divided into the experiment group and the control group with equal number. All patients were given conventional treatment after admission and was treated with ganglioside therapy continuously for 28 days. The experiment group was treated with hyperbaric oxygen therapy after the condition of patients was stable for 7 days, continuously treated for 20 days. For all patients of both groups before and after treatment, the area of cerebral edema was scanned by cranial CT, the levels of MBP were tested by ELISA, thrombin levels were tested by Automated Blood Coagulation Analyzer, level of NSE and S-100 protein were tested by ELISA; then, the patients cerebral-vascular Vmean, Qmean, DR and peripheral blood flow resistance were tested by Cerebral-vascular Function Analyzer. Adopting Scandinavian Cerebral Stroke Scale(SSS) and American National Institutes of Health NIHSS for evaluating the neuro-function of patients. Results: Compared with before treatment, the comparison of area of cerebral edema, MBP, thrombin, level of NSE and S-100 protein, Vmean, Qmean, DR and R values, SSS and NIH scores showed no statistical significance(P>0.05); after the treatment, the area of brain edema in both groups reduced, and the experiment group was significantly smaller than the control group(P<0.01). Serum MBP, thrombin, NSE and S-100 protein level, DR and R values, NIH scores decreased in the 2 groups compared with before treatment, and the experiment group showed a significant decrease, which was statistically significant(P<0.05 or P<0.01). The Vmean, Qmean and SSS scores in both groups increased after treatment, and the experiment group increase was more significant than the control group, which was statistically significant(P<0.01). Conclusion: The hyperbaric oxygen combined with gangliosides can significantly reduce the area of cerebral edema in patients with hypertensive intracerebral hemorrhage, significantly reduce the degree of neurological impairment in patients and improve cerebral vascular function.

关键词(KeyWords)： 高压氧;神经节苷脂;高血压脑出血;脑血管功能;神经功能
hyperbaric oxygen;gangliosides;hypertensive intracerebral hemorrhage;cerebral vascular function;neurological function

Abstract:

Keywords:

基金项目(Foundation): 淮安市卫生和计划生育委员会项目(HAB201725)

作者(Author): 万真,王金鑫,臧奎,薛青
WAN Zhen,WANG Jinxin,ZANG Kui,XUE Qing

DOI: 10.19367/j.cnki.1000-2707.2019.11.016

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