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目的:探讨高海拔地区高压氧治疗对高血压脑出血患者血清IL-6和TNF-α的影响。方法:选取曾在青海果洛州玛多、达日及玛沁地区(平均海拔均在4 000m以上)高血压脑出血患者60例,随机分为A、B两组,每组30例,两组均予以保守治疗,其中A组予以常规降血压、降颅压及神经营养等药物静点,B组在A组同等治疗的基础上于第7天病情平稳后实施高压氧治疗,在治疗1疗程(10天)期间第1天、3天、7天、10天空腹抽取静脉血,检测血清IL-6和TNF-α含量,并于A组在相应时间段内抽取静脉血检测血清IL-6和TNF-α含量,两组间进行比较研究。结果:B组患者接受高压氧治疗前及后第1、2天所检测血清IL-6和TNF-α含量与A组比较差异均不显著,无统计学意义(P>0.05);而B组在接受高压氧后第(3~10)天期间,所测定静脉血IL-6和TNF-α值下降程度较A组明显,差异显著具有统计学意义(P<0.05)。结论:在高海拔地区,针对高血压脑出血患者,接受高压氧治疗,更能抑制患者血清IL-6和TNF-α的增高,对缓解血肿造成的脑损伤、免疫反应、炎症反应,促进神经系统机能的回复及患者的康复方面具有重要积极的临床意义。
Objective: To investigate the effects of hyperbaric oxygen therapy on the levels of serum IL-6 and TNF-α in patients with hypertensive cerebral hemorrhage. Methods: Sixty patients with hypertensive intracerebral hemorrhage who had been in Maduo, Dayi and Maqin areas of Golmud in Qinghai Province (mean elevation above 4 000 m) were randomly divided into A and B groups of 30 and two The patients in group A were treated with conventional antihypertensive, intracranial pressure and neurotrophic drugs. Group B was treated with hyperbaric oxygen on the basis of the same treatment in group A on day 7, During the course of treatment (10 days), venous blood was drawn from the abdomen on the 1st, 3rd, 7th and 10th days. The contents of IL-6 and TNF-α in the serum were measured. In the group A, 6 and TNF-α levels were compared between the two groups. Results: The levels of serum IL-6 and TNF-α in group B before and after hyperbaric oxygen treatment were not significantly different from those in group A (P> 0.05), while those in group B The levels of IL-6 and TNF-αin the venous blood decreased significantly (P <0.05) on the 3rd (3rd) to 10th day after hyperbaric oxygen exposure compared with that of the A group (P <0.05). CONCLUSION: Hyperbaric oxygen therapy can inhibit the increase of serum IL-6 and TNF-α in patients with hypertensive intracerebral hemorrhage at high altitude. It is helpful to relieve the brain injury, immune response, inflammatory reaction, The response of system function and patient rehabilitation have important positive clinical significance.