摘要目的 探讨高压氧(HBO)联合脑心通胶囊对高血压脑出血患者血清脑源性神经营养因子(BDNF)、转化生长因子β1(TGF-β1)及血管内皮功能的影响.方法 选择2016年11月至2018年11月在三峡中心医院老年科就诊的80例高血压脑出血患者,按照数字表法随机分为观察组和对照组,每组40例.对照组患者口服脑心通胶囊,观察组在对照组基础上加用HBO治疗.观察组患者的临床疗效、NIHSS评分、Barthel指数(BI)评分、血管内皮功能及血清BDNF、TGF-β1水平的变化.结果 治疗3个疗程后,观察组总有效率(90.0％)明显高于对照组总有效率(72.5％)(P<0.05).2组患者治疗后NIHSS评分明显低于治疗前,且观察组治疗后评分低于对照组治疗后(P<0.05或P<0.01);2组患者治疗后BI评分较治疗前升高,且观察组治疗后评分高于对照组治疗后(P<0.05或P<0.01).2组患者治疗后血清NO水平较治疗前明显升高,且观察组治疗后高于对照组(P<0.05或P<0.01);2组患者ET-1水平较治疗前明显降低,且观察组治疗后低于对照组治疗后(P<0.05或P<0.01).与治疗前比较,2组患者治疗后BDNF、TGF-β1水平明显升高,且观察组治疗后高于对照组治疗后(P<0.05或P<0.01).结论 HBO联合脑心通胶囊通过上调血清BDNF、TGF-β1水平来降低炎性反应,改善高血压脑出血患者血管内皮功能,临床疗效好,安全性高,值得临床推广应用.

abstractsObjective To investigate the effects of hyperbaric oxygen ( HBO ) combined with Naoxintong capsules on serum BDNF, TGF-beta 1 and endothelial function of the patients with hypertensive intracerebral hemorrhage. Methods Eighty patients with hypertensive intracerebral hemorrhage who were hospitalized from November 2016 to November 2018 were randomly divided into the observation group and the control group, each consisting of 40 patients. The control group took Naoxintong capsules 3 times a day, while the treatment group was supplemented with HBO therapy in addition to the treatment received by the control group. The clinical efficacy, NIHSS scores, Barthel indexes, endothelial function and serum levels of brain-derived neurotrophic factor ( BDNF) and changes in the levels of TGF-beta 1 were closely observed. Results After 3 courses of treatment, the total effective rate of the observation group (90. 0％) was obviously higher than that (72. 5％) of the control group (P<0. 05). Following treatment, the NIHSS scores of the 2 groups were all lower than those before treatment, and the scores of the observation group after treatment were lower than those of the control group after treatment (P<0. 05 or P<0. 01). The BI scores of the 2 groups after treatment all elevated, as compared with those before treatment, and the scores of the observation group after treatment were higher than those of the control group after treatment (P<0. 05 or P<0. 01). The NO levels of the 2 groups after treatment all increased prominently as compared with those before treatment, and the NO level&nbsp;of the observation group after treatment were higher than those of the control group after treatment (P<0. 05 or P<0. 01). The ET-1 levels of the 2 groups after treatment all decreased considerably as compared with those before treatment, and the ET-1 level of the observation group after treatment was lower than that of the control group after treatment (P<0. 05 or P<0. 01). As compared with those before treatment, the BDNF and TGF-β-1 levels of the 2 groups after treatment all elevated markedly, and those of the observation group after treatment were higher than those of the control group after treatment (P<0. 05 or P<0. 01). Conclusion Through the regulation of serum BDNF and TGF-β1 levels and the decrease of inflammatory response, HBO combined with Naoxintong capsules could improve neuroendothelial function in the patients with hypertensive intracerebral hemorrhage, with sound clinical efficacy and good safety. For this reason, it was worth further clinical promotion.