摘要目的:分析早期高压氧治疗对急性脑梗死患者血清学指标及糖代谢的影响。方法:选取上海市中西医结合医院收治的急性脑梗死患者84例作为研究对象，按照随机数字表法分为对照组（ n=42）与观察组（ n=42）。对照组给予常规治疗，观察组在常规治疗基础上给予早期高压氧治疗。比较2组患者的临床疗效，治疗前后美国国立卫生研究院卒中量表（NIHSS）评分、血清学指标［脂质过氧化氢（LHP）、活性氧（ROS）、过氧化氢酶（CAT）、超氧化物歧化酶（SOD）、胶质纤维酸性蛋白（GFAP）、神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）、淀粉样蛋白A（SAA）］、红细胞糖代谢相关指标［己糖激酶、葡萄糖-6-磷酸脱氢酶（G6PD）、磷酸果糖激酶（PFK）］及血液流变学指标变化。 结果:观察组治疗总有效率（97.62%，41/42）高于对照组（76.19%，32/42），差异有统计学意义（ χ2=8.473， P<0.05）。与治疗前比较，2组患者治疗后NIHSS评分均明显降低，且观察组明显低于对照组［（7.52±0.71）分比（10.72±1.14）分］；2组患者治疗后血清学指标均明显改善，且观察组［LHP（230.59±31.26）μmol/L、ROS（302.72±32.58）U/ml、GFAP（7.38±0.71）pg/ml、NSE（1.79±0.25）ng/ml、MBP（24.58±3.13）pg/ml、SAA（3.22±0.45）mg/L］均明显低于对照组［LHP（352.83±39.41）μmol/L、ROS（517.36±45.61）U/ml、GFAP（12.64±1.56）pg/ml、NSE（3.95±0.52）ng/ml、MBP（45.32±6.34）pg/ml、SAA（6.39±0.78）mg/L］；观察组［CAT（7.98±0.77）U/ml、SOD（68.35±7.98）U/L］均明显高于对照组［CAT（5.13±0.59）U/ml、SOD（52.24±6.17）U/L］；2组患者治疗后红细胞糖代谢相关指标均明显改善，且观察组己糖激酶［（0.74±0.13）U/L］明显低于对照组［（1.17±0.26）U/L］，G6PD［（6.65±2.07）U/hHb］、PFK［（17.58±2.92）U/L］均明显高于对照组［G6PD（3.07±1.22）U/hHb、PFK（12.08±2.10）U/L］；2组患者治疗后血液流变学指标均明显降低，且观察组纤维蛋白原［（2.53±0.16）g/L］、红细胞比容［（29.94±3.12）%］、红细胞沉降率［（17.36±2.14）mm/h］均明显低于对照组［纤维蛋白原（3.70±0.41）g/L、红细胞比积（38.94±3.47）%、红细胞沉降率（25.38±2.81）mm/h］，差异均有统计学意义（均 P<0.05）。 结论:早期高压氧治疗急性脑梗死患者有助于提高临床疗效，改善神经功能及红细胞糖代谢水平，调节氧化应激反应及血液流变学指标，减轻神经元损伤。

abstractsObjective:To analyze the effect of early hyperbaric oxygen therapy on serological indicators and glucose metabolism in patients with acute cerebral infarction.Methods:A total of 84 patients with acute cerebral infarction admitted to Shanghai TCM - Integrated Hospital were selected and randomly divided into a control group（ n=42）and an observation group（ n=42）. The control group received conventional treatment，while the observation group received early hyperbaric oxygen therapy in addition to the conventional treatment. The clinical efficacy was compared between the two groups. The National Institutes of Health stroke scale（NIHSS）scores，serological markers［lipid hydroperoxide（LHP），reactive oxygen species（ROS），catalase（CAT），superoxide dismutase（SOD），glial fibrillary acidic protein（GFAP），neuron-specific enolase（NSE），myelin basic protein（MBP），and serum amyloid A（SAA）］，erythrocyte glucose metabolism-related indices［hexokinase，glucose-6-phosphate dehydrogenase（G6PD），phosphofructokinase（PFK）］，and hemorheological parameters were compared between the two patient groups before and after treatment. Results:The treatment effective rate in the observation group（97.62%，41/42）was significantly higher than that in the control group（76.19%，32/42），with a statistically significant difference（ χ2=8.473， P<0.05）. Compared with before treatment，NIHSS scores significantly decreased in both groups post-treatment，with the observation group showing markedly lower scores than the control group［（7.52 ± 0.71）points vs.（10.72 ± 1.14）points］. Serological indicators showed substantial improvement in both groups after treatment，with the observation group exhibiting significantly lower levels of LHP［（230.59 ± 31.26）μmol/L vs.（352.83 ± 39.41）μmol/L］，ROS［（302.72 ± 32.58）U/ml vs.（517.36 ± 45.61）U/ml］，GFAP［（7.38 ± 0.71）pg/ml vs.（12.64 ± 1.56）pg/ml］，NSE［（1.79 ± 0.25）ng/ml vs.（3.95 ± 0.52 ng/ml）］，MBP［（24.58 ± 3.13）pg/ml vs.（45.32 ± 6.34）pg/ml］，and SAA［（3.22 ± 0.45）mg/L vs.（6.39 ± 0.78）mg/L］compared to the control group. Conversely，the observation group demonstrated significantly higher levels of CAT［（7.98 ± 0.77）U/ml vs.（5.13 ± 0.59）U/ml］and SOD［（68.35 ± 7.98）U/L vs.（52.24 ± 6.17）U/L］. Erythrocyte glucose metabolism-related indices also improved after treatment in both groups，with the observation group showing significantly lower hexokinase［（0.74 ± 0.13）U/L vs.（1.17 ± 0.26 U/L）and higher G6PD［（6.65 ± 2.07）U/hHb vs.（3.07 ± 1.22）U/hHb］and PFK［（17.58 ± 2.92）U/L vs.（12.08 ± 2.10）U/L］than the control group. Hemorheological parameters were significantly reduced following treatment in both groups，and the observation group exhibited notably lower fibrinogen［（2.53 ± 0.16）g/L vs.（3.70 ± 0.41）g/L］，hematocrit［（29.94 ± 3.12）% vs.（38.94 ± 3.47）%），and erythrocyte sedimentation rate［（17.36 ± 2.14）mm/h vs.（25.38 ± 2.81）mm/h）compared with the control group. All intergroup differences were statistically significant（all P<0.05）. Conclusion:Early hyperbaric oxygen therapy for patients with acute cerebral infarction helps improve clinical efficacy，neurological function，and red blood cell glucose metabolism levels，regulates oxidative stress responses and hemorheological indicators，and reduces neuronal damage，thus making it worthy of clinical promotion.