Chen Yuwen, Wang Liang, You Wenjun, Huang Fei, Jiang Yingzi, Sun Li, Wang Siye, Liu Su
Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong, China.
School of Medicine, Nantong University, Nantong, China.
Front Neurol. 2022 Aug 10;13:929386. doi: 10.3389/fneur.2022.929386. eCollection 2022.
The aim of this study was to investigate the clinical curative effect of hyperbaric oxygen (HBO) treatment and its mechanism in improving dysfunction following traumatic brain injury (TBI).
Patients were enrolled into control and HBO groups. Glasgow coma scale (GCS) and coma recovery scale-revised (CRS-R) scores were used to measure consciousness; the Rancho Los Amigos scale-revised (RLAS-R) score was used to assess cognitive impairment; the Stockholm computed tomography (CT) score, quantitative electroencephalography (QEEG), and biomarkers, including neuron-specific enolase (NSE), S100 calcium-binding protein beta (S100β), glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and vascular endothelial growth factor (VEGF), were used to assess TBI severity. The patients were followed up 6 months after discharge and assessed with the Glasgow outcome scale-extended (GOSE), functional independence measure (FIM), and the disability rating scale (DRS).
The CRS-R scores were higher in the HBO group than the control group at 10 days after treatment. The RLAS-R scores were higher in the HBO group than the control group at 10 and 20 days after treatment. The Stockholm CT scores were significantly lower in the HBO group than the control group at 10 days after treatment. HBO depressed the (δ + θ)/(α + β) ratio (DTABR) of EEG, with lower δ band relative power and higher α band relative power than those in the control group. At 20 days after treatment, the expression of NSE, S100β, and GFAP in the HBO group was lower than that in controls, whereas the expression of BDNF, NGF, and VEGF in the HBO group was higher than that in controls. Six months after discharge, the HBO group had lower DRS scores and higher FIM and GOSE scores than the control group significantly.
HBO may be an effective treatment for patients with TBI to improve consciousness, cognitive function and prognosis through decreasing TBI-induced hematoma volumes, promoting the recovery of EEG rhythm, and modulating the expression of serum NSE, S100β, GFAP, BDNF, NGF, and VEGF.
本研究旨在探讨高压氧（HBO）治疗对创伤性脑损伤（TBI）后功能障碍的临床疗效及其机制。
将患者分为对照组和HBO组。采用格拉斯哥昏迷量表（GCS）和改良昏迷恢复量表（CRS-R）评分来衡量意识；采用改良的兰乔斯阿米戈斯量表（RLAS-R）评分来评估认知障碍；采用斯德哥尔摩计算机断层扫描（CT）评分、定量脑电图（QEEG）以及生物标志物，包括神经元特异性烯醇化酶（NSE）、S100钙结合蛋白β（S100β）、胶质纤维酸性蛋白（GFAP）、脑源性神经营养因子（BDNF）、神经生长因子（NGF）和血管内皮生长因子（VEGF），来评估TBI的严重程度。患者出院后随访6个月，并用扩展格拉斯哥预后量表（GOSE）、功能独立性测量（FIM）和残疾评定量表（DRS）进行评估。
治疗10天后，HBO组的CRS-R评分高于对照组。治疗10天和20天后，HBO组的RLAS-R评分高于对照组。治疗10天后，HBO组的斯德哥尔摩CT评分显著低于对照组。HBO降低了脑电图的（δ + θ）/（α + β）比值（DTABR），其δ频段相对功率低于对照组，α频段相对功率高于对照组。治疗20天后，HBO组中NSE、S100β和GFAP的表达低于对照组，而HBO组中BDNF、NGF和VEGF的表达高于对照组。出院6个月后，HBO组的DRS评分低于对照组，FIM和GOSE评分显著高于对照组。
HBO可能是治疗TBI患者的一种有效方法，可通过减少TBI引起的血肿体积、促进脑电图节律恢复以及调节血清NSE、S100β、GFAP、BDNF、NGF和VEGF的表达来改善意识、认知功能和预后。
