【摘要】 目的:探讨高压氧(HBO)治疗对不同体积脑梗死患者血清可溶性细胞间黏附分子-1(sICAM-1)含量的影响及临床疗效观察。方法:采用酶联免疫吸附法对20例健康人(对照组)、50例HBO加常规治疗组(HBO组)和50例常规治疗组(常规组)的急性脑梗死患者在入院1、7、14d进行血清sICAM-1含量的动态监测,按病灶大小分大、中、小不同体积梗死组,并进行组间比较;于入院1、14d对神经功能缺失进行评分,评价患病两组疗效差异。结果:入院1d时大体积组脑梗死患者血清sICAM-1含量高于中、小体积组,中体积组高于小体积组(P<0.01)。各体积组血清sICAM-1含量均高于对照组(P<0.01)。入院7、14d,HBO组与常规组各梗死体积组内患者血清sICAM-1含量逐渐降低,2个时间点相比差异有显著性(P<0.01)。入院1dHBO各体积组与常规组对应体积组比较,血清sICAM-1含量差异无显著性,而7、14d,该指标均低于对应体积和时间点的常规组(P<0.01),除了7d时HBO大体积组sICAM-1含量较常规组的大体积组无明显差异。入院14dHBO组神经功能缺失评分明显低于常规组,两组总有效率差异有显著性(P<0.05)。结论:脑梗死患者血清sICAM-1含量与梗死体积密切相关。HBO治疗能降低不同体积脑梗死患者血清sICAM-1的含量,减轻炎症损伤,提高临床疗效。更多还原

【Abstract】 Objective To investigate the effect of hyperbaric oxygen therapy (HBOT) on levels of serum soluble intercellular adhesion molecule-1 (sICAM-1) in patients with acute cerebral infarction (ACI) and to observe the efficacy of HBOT. Methods Serum sICAM-1 levels were measured by ELISA in 50 patients receiving HBOT plus routine treatment (HBOT group),50 receiving routine treatment alone (routine group),and 20 healthy people (control group) on days 1,7,and 14 of admission. The two treatment groups were further subdivided into small,moderate,and large infarct-volume groups based on lesion size; the results were compared among all groups. The clinical neurological deficit was graded on days 1 and 14 to assess the efficacy in two treatment groups. Results On day 1,the sICAM-1 levels in the moderate infarct-volume group were significantly higher than those in the small infarct-volume group,while lower than those in the large infarct-volume group (P < 0.01 for all comparisons). As compared with the control group,the sICAM-1 levels were higher in the two treatment groups (P < 0.01 for all comparisons). sICAM-1 levels declined gradually from day 7 in the two treatment groups and the decreased level differed significantly on days 7 and 14. The sICAM-1 levels did not differ significantly between the HBOT group and the routine group on day 1,but was decreased more obviously in the HBOT group than in the routine group on days 7 and 14 (P < 0.01),except in the large infarct-volume group on day 7. On day 14,the neurological deficit scores were markedly lower in the HBOT group than in the routine group; and the efficacy differed significantly between the two groups (P < 0.05). Conclusions In patients with ACI,serum sICAM-1 level is closely associated with cerebral infarct volume; HBOT can lower serum sICAM-1 levels,alleviate the inflammatory damage to infarction,and improve the clinical outcomes.更多还原