Xu Qian, Wei Yi-Ting, Fan Shuang-Bo, Wang Liang, Zhou Xiao-Ping
Department of Brain Surgery, Ningbo Zhenhai Longsai Hospital, Zhejiang, People's Republic of China.
Neuropsychiatr Dis Treat. 2017 Feb 10;13:421-426. doi: 10.2147/NDT.S126288. eCollection 2017.
The role of hyperbaric oxygen therapy (HBOT) in the treatment of acute ischemic stroke is controversial. This study aims to investigate whether the peripheral insulin sensitivity of type 2 diabetes patients suffering from intracerebral hemorrhage can be increased after HBOT.
Fifty-two type 2 diabetes participants were recruited after being diagnosed with intracerebral hemorrhage in our hospital. Insulin sensitivity was measured by the glucose infusion rate during a hyperinsulinemic euglycemic clamp (80 mU m min) at baseline and 10 and 30 days after HBOT sessions. Serum insulin, fasting glucose, and hemoglobin A1 were measured in fasting serum at baseline and after HBOT sessions. In addition, early (∼10 days after onset) and late (1 month after onset) outcomes (National Institutes of Health Stroke Scale, NIHSS scores) and efficacy (changes of NIHSS scores) of HBOT were evaluated.
In response to HBOT, the glucose infusion rate was increased by 37.8%±5.76% at 1 month after onset compared with baseline. Reduced serum insulin, fasting glucose, and hemoglobin A1 were observed after HBOT. Both early and late outcomes of the HBOT group were improved compared with baseline (<0.001). In the control group, there was significant difference only in the late outcome (<0.05). In the assessment of efficacy, there were statistically significant differences between the groups when comparing changes in NIHSS scores at 10 days and 1 month after onset (<0.05).
Peripheral insulin sensitivity was increased following HBOT in type 2 diabetes patients with intracerebral hemorrhage. The HBOT used in this study may be effective for diabetes patients with acute stroke and is a safe and harmless adjunctive treatment.
高压氧疗法(HBOT)在急性缺血性脑卒中治疗中的作用存在争议。本研究旨在探讨2型糖尿病脑出血患者接受HBOT后外周胰岛素敏感性是否会提高。
选取我院确诊为脑出血的52例2型糖尿病患者。在基线、HBOT治疗后10天和30天,通过高胰岛素正常血糖钳夹试验(80 mU m min)期间的葡萄糖输注率测量胰岛素敏感性。在基线和HBOT治疗后,检测空腹血清中的血清胰岛素、空腹血糖和糖化血红蛋白A1。此外,评估HBOT的早期(发病后约10天)和晚期(发病后1个月)结局(美国国立卫生研究院卒中量表,NIHSS评分)及疗效(NIHSS评分变化)。
与基线相比,发病后1个月时,HBOT治疗使葡萄糖输注率提高了37.8%±5.76%。HBOT治疗后,血清胰岛素、空腹血糖和糖化血红蛋白A1降低。与基线相比,HBOT组的早期和晚期结局均得到改善(<0.001)。在对照组中,仅晚期结局有显著差异(<0.05)。在疗效评估中,发病后10天和1个月时,比较两组NIHSS评分变化,差异有统计学意义(<0.05)。
2型糖尿病脑出血患者接受HBOT后外周胰岛素敏感性提高。本研究中使用的HBOT可能对急性脑卒中糖尿病患者有效,是一种安全无害的辅助治疗方法。