内科

【摘要】目的探讨在常规治疗的基础上，早期高压氧治疗对脑缺氧缺血再灌注损伤患者CRP、NO、Bcl2和乳酸水平的影响。方法随机选取在我院诊治的缺血缺氧性脑病患者85例作为研究对象，在常规治疗的基础上给予早期高压氧治疗，观察治疗前、治疗后1天、7天和14天患者的脑血容量（CBV）、脑血流量（CBF）和脑血流平均通过时间（MTT）变化情况，检测患者血清炎性因子CRP、一氧化氮（NO）、抗凋亡蛋白Bcl2和乳酸水平。结果随着治疗时间的延长，患者MTT明显缩短；CBV、CBF水平明显升高，治疗第7天时CBV、CBF水平达高峰，不同治疗时间段血流灌注各项指标水平比较差异具有统计学意义（P＜0.05）；随着治疗时间的延长，患者血清炎性因子CRP和乳酸水平逐渐降低，NO和Bcl2水平逐渐增加，不同治疗时间段CRP、乳酸、NO和Bcl2水平比较差异具有统计学意义（P＜0.05）。结论高压氧治疗可能是通过改善微循环、调节抗凋亡蛋白Bcl2水平、减轻炎症及应激反应而减轻脑缺氧缺血患者的再灌注损伤，发挥有效的神经保护作用。

【Abstract】ObjectiveTo investigate the effect of early hyperbaric oxygen therapy on CRP、NO、Bcl2 in patients with cerebral ischemia/reperfusion injury.MethodsA total of 85 patients with cerebral ischemia/reperfusion injury treated in our hospital were enrolled as the research objects, all patients received early hyperbaric oxygen therapy on the basis of conventional therapy, cerebral blood volume (CBV), cerebral blood flow (CBF), cerebral blood mean transit time (MTT) of patients were observed before treatment, at 1 day, 7 days, 14 days after treatment, the level of CRP, NO, Bcl2 and blood lactic acid were also detected. ResultsWith the duration of treatment, MTT decreased significantly; CBV, CBF increased significantly, and CBV, CBF were up to the peak at 7 days after treatment, there was significant difference in blood flow index among different treatment time (P＜0.05); with the duration of treatment, the levels of CRP and blood lactic acid were gradually decreased, while the levels of NO, Bcl2 were gradually increased, there was significant difference in the levels of CRP, NO, Bcl2, blood lactic acid among different treatment time (P＜0.05). ConclusionsHyperbaric oxygen therapy can alleviate cerebral perfusion injury, protect nerve by improving microcirculation, regulating the level of Bcl2, reducing inflammation and stress response.