摘要目的 探讨高压氧治疗对急性脊髓损伤患者血浆HMGB1/NF-κB表达的影响.方法 经患者知情同意,将82例急性脊髓损伤患者分为对照组(常规治疗)40例和治疗组(常规治疗+高压氧治疗)42例.在治疗前、治疗后第1、3、7、10、30天相同时间点,采用ELISA法检测患者血浆HMGB1/NF-κB水平,应用脊髓ASIA损伤分级评价总有效率.结果 对照组急性脊髓损伤患者血浆HMGBI水平升高,峰值出现在治疗后第3天.治疗组患者治疗后血浆HMGB1水平降低,与对照组比较,在治疗后第3、7、10、30天差异具有统计学意义(P＜0.01),高压氧治疗后第30天血浆HMGB1水平依然高于损伤时的基线值.对照组血浆NF-κB水平升高,峰值出现在治疗后第1天.治疗组患者治疗后血浆NF-κB水平降低,与对照组比较,在治疗后第3、7天(P＜0.05)、第10、30天(P＜0.01)差异具有统计学意义(P＜0.01),高压氧治疗后第30天血浆NF-κB水平明显低于损伤时的基线值.与对照组(70.0％)比较,高压氧治疗组总有效率为85.7％,差异有统计学意义(P＜0.05).结论 高压氧可通过降低外周血HMGB1/NF-κB水平,减轻急性脊髓损伤患者继发性损伤中的炎症反应,促进患者神经功能修复.

abstractsObjective To investigate the effect of hyperbaric oxygen (HBO) on the expression level of plasma HMGB1/NF-κB in patients with acute spinal cord injury.Methods With the knowledge and consent of the patients,82 cases of acute spinal cord injury were divided into the control group (or the routine treatment group) (n =40) and the treatment group (or the routine treatment + HBO therapy group) (n =42).Plasma levels of HMGB1/NF-kappa B (kB) were detected by ELISA,both before treatment and at the same time points of day 3,7,10 and 30 after treatment.Total effective rate was evaluated by using ASIA scores of spinal cord injury.Results The plasma HMGB1 levels of the patients with acute spinal cord injury in the control group were elevated,and the peak value was at day 3 after treatment.The plasma HMGB1 levels of the patients in the HBO group were decreased after HBO treatment.Statistical differences in the plasma HMGB1 levels could be seen at day 3,7,10 and 30 after treatment,as compared with those of the control group (P ＜ 0.01).However,the plasma HMGB1 level at day 30 following HBO therapy was still higher than that of the baseline at the time of injury.The plasma NF-kB levels for the patients of the control group were decreased,with the peak level at day 1 after treatment.As compared with those of the control group,the levels of plasma NF-kB for the patients of the HBO group were also decreased,and statistical significance could be noted in its levels at day 3,7 and 30 after treatment (P ＜ 0.01).The level of NF-kB at day 30 after HBO was significantly lower than that of the baseline at the time of injury.Total effective rate for the HBO group was 85.7％,as compared with that of the control group (70.0％),and statistical significance could be noticed,when comparisons were made between them (P ＜ 0.05).Conclusions HBO therapy could decrease inflammatory reaction of secondary injury by decreasing HMGB1/ NF-kappa B levels in peripheral blood,and promote recovery of neurological function in patients with acute spinal cord injury.