高压氧联合丁苯酞对急性脑梗死患者神经功能及血清Ang-1 THBS-1和Bcl-2水平的影响

doi:10.3969/j.issn.1006-6233.2023.12.014

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摘要 目的: 观察高压氧联合丁苯酞对急性脑梗死患者神经功能及血清Ang-1、THBS-1和Bcl-2水平的影响。方法: 前瞻性选取2021年5月至2023年1月收治的112例急性脑梗死患者为研究对象,采用完全随机法分为两组。两组均给予常规药物治疗,丁苯酞组56例给予丁苯酞治疗,高压氧组56例给予高压氧联合丁苯酞治疗。比较两组美国国立卫生研究院脑卒中量表(NIHSS)评分、Barthel(BI)指数、改良Rankin量表(mRS)评分的差异,检测两组脑血流灌注、Ang-1、THBS-1、Bcl-2的水平,统计两组疗效和不良反应。结果: 两组治疗前相关评分比较,差异无统计学意义(P>0.05)。与本组治疗前比较,高压氧组和丁苯酞组NIHSS评分、mRS评分均降低,BI指数均升高,高压氧组降低及升高幅度大于丁苯酞组(P<0.05)。两组治疗前脑血流灌注比较,差异无统计学意义(P>0.05)。与本组治疗前比较,高压氧组和丁苯酞组脑血流量(CBF)、脑血容量(CBV)均升高,高压氧组升高幅度大于丁苯酞组(P<0.05)。两组治疗前Ang-1、THBS-1、Bcl-2比较,差异无统计学意义(P>0.05)。与本组治疗前比较,高压氧组和丁苯酞组Ang-1、Bcl-2均升高,THBS-1均降低高压氧组升高及降低幅度大于丁苯酞组(P<0.05)。高压氧组总有效率为94.64%(53/56),高于丁苯酞组的82.14%(46/56),不良反应与丁苯酞组比较,差异无统计学意义(P>0.05)。结论: 高压氧联合丁苯酞对急性脑梗死可改善脑血流灌注,调节Ang-1、THBS-1、Bcl-2的表达,改善神经功能,提高患者独立性。

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	李娜
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关键词 ：高压氧, 丁苯酞, 急性脑梗死, 脑血流灌注, 神经功能

Abstract：Objective: To observe the effects of hyperbaric oxygen combined with butylphthalide on neurological function and serum levels of Ang-1, THBS-1, and Bcl-2 in patients with acute ischemic stroke. Methods: A total of 112 patients with acute ischemic stroke admitted from May 2021 to January 2023 were prospectively selected as the study subjects and divided into two groups using a completely random method. Both groups received conventional medication, with 56 patients in the Butylphthalide group receiving butylphthalide treatment and 56 patients in the Hyperbaric Oxygen group receiving hyperbaric oxygen combined with butylphthalide treatment. The differences in NIHSS score, Barthel Index (BI), and modified Rankin Scale (mRS) score between the two groups were compared. Additionally, brain blood flow perfusion, levels of Ang-1, THBS-1, and Bcl-2 were detected, and treatment efficacy and adverse reactions were statistically analyzed. Results: There was no statistically significant difference in the relevant scores before treatment in both groups (P>0.05). Compared with before treatment, the NIHSS and mRS scores decreased, while the BI index increased in both the Hyperbaric Oxygen and Butylphthalide groups, with greater reductions and increases observed in the Hyperbaric Oxygen group than in the Butylphthalide group (P<0.05). There was no statistically significant difference in brain blood flow perfusion before treatment between the two groups (P>0.05). Compared with before treatment, both the Hyperbaric Oxygen and Butylphthalide groups showed an increase in cerebral blood flow (CBF) and cerebral blood volume (CBV), with a greater increase observed in the Hyperbaric Oxygen group than in the Butylphthalide group (P<0.05). There was no statistically significant difference in Ang-1, THBS-1, and Bcl-2 levels before treatment between the two groups (P>0.05). Compared with before treatment, both the Hyperbaric Oxygen and Butylphthalide groups showed an increase in Ang-1 and Bcl-2 levels, and a decrease in THBS-1 levels, with a greater increase and decrease observed in the Hyperbaric Oxygen group than in the Butylphthalide group (P<0.05). The total effective rate in the Hyperbaric Oxygen group was 94.64% (53/56), higher than the Butylphthalide group's 82.14% (46/56), and there was no statistically significant difference in adverse reactions compared to the Butylphthalide group (P>0.05). Conclusion: Hyperbaric oxygen combined with butylphthalide can improve cerebral blood flow perfusion, regulate the expression of Ang-1, THBS-1, and Bcl-2, improve neurological function, and enhance patient independence.

Key words： Hyperbaric oxygen Butylphthalein Acute cerebral infarction Cerebral blood perfusion Neural function

基金资助:北京市科技计划课题,(编号:Z191100006619028);首都医科大学2022年度科技计划、社科计划一般项目,(编号:KM202210025002)

通讯作者: 孟祥恩

引用本文:

李娜, 王圣元, 孟祥恩. 高压氧联合丁苯酞对急性脑梗死患者神经功能及血清Ang-1 THBS-1和Bcl-2水平的影响[J]. 河北医学, 2023, 29(12): 2011-2016.
LI Na, WANG Shengyuan, MENG Xiangen. Impact of Hyperbaric Oxygen Combined with Butylphthalide on Neurological Function and Serum Levels of Ang-1 THBS-1 and Bcl-2 in Patients with Acute Ischemic Stroke. HeBei Med, 2023, 29(12): 2011-2016.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.12.014 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I12/2011

[1] 赵丽姣,杨松海,陈善鹏,等.老年急性脑梗死患者阿替普酶静脉溶栓后疗效观察及相关因素分析[J].脑与神经疾病杂志,2023,31(3):180-185.
[2] 王琴,孔伟丽,吕康,等.氯吡格雷联合丁苯酞注射液治疗急性脑梗死的效果及对抗氧化能力的影响[J].临床误诊误治,2021,34(4):39-43.
[3] 周慧文.高压氧联合丁苯酞治疗急性脑梗死的效果分析[J].中国临床医生杂志,2023,51(1):50-52.
[4] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[5] 韩楠楠,常明则,张格娟,等.侧支代偿联合NIHSS评分预测大脑中动脉闭塞患者的预后[J].卒中与神经疾病,2019,26(1):60-63.
[6] 吴炜,倪波业,施加加.扩展Barthel指数在脑卒中患者中的信度与效度[J].中国康复理论与实践,2021,27(3):261-268.
[7] 袁俊亮,张晓丹,李海英,等.smRSq量表在部分中国脑卒中人群中信度和效度的初步研究[J].临床神经病学杂志,2016,29(3):161-163.
[8] 梁菊萍,杨旸,董继存.急性脑梗死患者流行病学调查及危险因素[J].中国老年学杂志,2021,41(12):2484-2487.
[9] 张素侠,钟宝权,何晓晓,等.瑞替普酶对老年脑梗死患者的治疗效果[J].中华老年多器官疾病杂志,2020,19(7):541-544.
[10] 吴云虹,周辉,陈薇,等.丁苯酞序贯联合静脉溶栓对急性脑梗死患者sdLDL-C、Annexin A2、Hcy及预后的影响[J].河北医学,2022,28(6):1020-1024.
[11] 夏祝叶,胡兰兰,姜丽静,等.高压氧治疗急性脑梗死的临床观察[J].血栓与止血学,2022,28(3):361-363.
[12] Kesnerova,Petra,Skoloudik,et al.Peripheral vascular resistance in cerebral arteries in patients with carotid atherosclerosis - substudy results of the atherosclerotic plaque characteristics associated with a progression rate of the plaque and a risk of stroke in patients with the carotid bifurcation plaque study (ANTIQUE)[J].Journal of Ultrasound in Medicine:Official Journal of the American Institute of Ultrasound in Medicine,2022,41(1):237-246.
[13] Parikh,Neal S,Gottesman,et al.Midlife cardiovascular risk factors,subclinical atherosclerosis,and cerebral hypometabolism[J].Journal of the American College of Cardiology,2021,77(7):899-901.
[14] 杨丽花,丁凌,徐敏,等.血清Hcy、THBS-1、颈动脉超声血流参数预测缺血性脑卒中患者预后的价值[J].国际检验医学杂志,2022,43(21):2591-2595.
[15] Thea Vigen,Hakon Ihle-hansen,Magnus N Lyngbakken,et al.Carotid atherosclerosis is associated with middle cerebral artery pulsatility index[J].Journal of neuroimaging,2020,30(2):233-239.