文章摘要
薛磊,范建中.高压氧综合治疗重型颅脑损伤患者血液相关指标的动态研究[J].中华物理医学与康复杂志,2003,(7):.-
高压氧综合治疗重型颅脑损伤患者血液相关指标的动态研究
  
DOI:
中文关键词: 高压氧  丙二醛  超氧化物歧化酶  血浆内皮素  血管紧张素Ⅱ
英文关键词: Hyperbaric oxygenation  Malondialdehyde  Superoxide dismutase  Plasma endothelin  AngiotensinⅡ  Brain injury
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薛磊,范建中 510515广州第一军医大学南方医院高压氧科(薛磊)康复医学科(范建中) 
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中文摘要:
      目的探讨高压氧(HBO)综合治疗重型闭合性颅脑损伤前、后患者的丙二醛(MDA)、超氧化物歧化酶-1(SOD-1)及血浆内皮素(ET)和血管紧张素(AⅡ)的变化,及其与格拉斯哥昏迷计分(GCS)、格拉斯哥预后量表(GOS)评分和预后的关系。 方法HBO组32例,行外科常规治疗、综合治疗和HBO治疗;对照组18例,行外科常规治疗和综合治疗;健康志愿者30名为正常组。治疗前、后用硫代巴比妥酸比色法检测MDA、用放射免疫法检测SOD-1、ET和AⅡ。 结果治疗前对照组和HBO组4项指标与正常组比较差异均有显著性(P<0.01);GCS 3~5分组和6~8分组4项指标比较差异有显著性(P<0.05);MDA、ET和AⅡ值高伴SOD-1值低者GCS记分低。治疗后对照组和HBO组的6~8分组4项指标和HBO组的3~5分组ET、AⅡ与正常组比较差异无显著性(P>0.05),对照组的3~5分组4项指标和HBO组的3~5分组SOD-1、MDA与正常组比较差异显著(P<0.05);MDA、ET和AⅡ值降低伴SOD-1值升高者GCS评分高;HBO组GCS评分和GOS预后评分均较对照组改变明显(P<0.05)。 结论SOD-1 、MDA、ET和AⅡ与损伤严重程度有关,可用于判断HBO综合治疗效果及患者预后。
英文摘要:
      Objective To observe the changes of malondialdehyde (MDA), superoxide dismutase (SOD-1) in serum and plasma endothelin (ET)and angiotensin II(AⅡ) in patients with severe closed head injury before and after being treated with hyperbaric oxygenation (HBO). MethodsFifty patients were recruited. Thirty-two patients were treated with HBO in addition to the conventional management (HBO group) and the other eighteen patients without HBO except for conventional management served as the controls (control group). Thirty healthy volunteers served as normal controls (normal group). Activities of MDA ,SOD-1,ET and AII were measured with spectrometry and radioimmunoassay in all the subjects, respectively, during the study. Results Before treatment, there was a significant difference between the normal group and HBO group as well as the control group in regard to the activities of the 4 parameters(P<0.01). There was a significant difference between patients scored 3-5 with GCS and those scored 6-8 with GCS in regard to the activities of the 4 parameters(P<0.05). Relative lower GCS was found in patients with higher MDA ,ET and AⅡand lower SOD-1. After treatment with HBO, the difference between the HBO group and the control group was not significant (P>0.05) as the 4 parameters were concerned. The patients scored 3-5 with GCS in the control group were significantly different from those scored the same with GCS in the normal group in terms of the SOD-1 and MDA. Higher GCS was found in patients with low activities of MDA, ET and AII but high SOD-1 levels. Favourable changes of GCS and GOS were observed in patients in the HBO group as compared with those in the control group (P<0.05). Conclusion The levels of SOD-1, MDA, ET and AII are closely related to the severity of brain injuries, and thus could be used as an index of therapeutic effectiveness and prognosis for patients with brain injury.
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