Effects of different courses of hyperbaric oxygen therapy on vulnerable carotid atherosclerotic plaque and related inflammatory factors in patients with acute cerebral infarction
10.3760/cma.j.cn311847-20210922-00258
- VernacularTitle:不同疗程高压氧治疗对急性脑梗死患者颈动脉粥样硬化易损斑块及相关炎性因子的影响
- Author:
Lili DU
1
;
Quntao YU
;
Ying WANG
;
Mingzhen LI
;
Wenjun YANG
;
Jincheng ZHANG
Author Information
1. 264001 山东省烟台，烟台市烟台山医院神经内科
- Publication Type:Journal Article
- Keywords:
Cerebral infarction;
Hyperbaric oxygen;
Carotid atherosclerosis;
Matrix metalloproteinase-9;
C-reactive protein
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2021;28(6):732-737
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the effects of different courses of hyperbaric oxygen (HBO) on vulnerable carotid atherosclerotic (AS) plaque and related inflammatory factors in patients with acute cerebral infarction (ACI), and to explore its mechanism.Methods:A total of 176 patients with ACI treated in the Department of Neurology of Yantai Mountain Hospital and Yantai Yuhuangding Hospital from January 30, 2018 to December 30, 2020 were selected and divided into control group ( n=86) and observation group ( n=90) according to the treatment methods. Doppler ultrasound was used to check whether ACI patients were complicated with carotid AS plaque. And the patients who died and lost contact during the observation period were excluded. Ultimately, there were 69 cases in the control group and 72 cases in the observation group. The control group was given conventional treatment, while the patients in the observation group were treated with HBO on the basis of the treatment in the control group when they were in stable conditions. Before treatment and after 6 and 12 courses of treatment, the internal carotid artery (ICA) color Doppler ultrasound was performed to check the degree of sclerosis and stenosis, the reduction of vulnerable plaque, and the increase of stable plaque, and to measure the plaque thickness, intima-media thickness (IMT), and long diameter. Before treatment and after 2 and 4 courses of treatment, the levels of matrix metalloproteinase-9 (MMP-9), C-reactive protein (CRP), endothelin (ET), and homocysteine (Hcy) were measured. Results:Compared with that before treatment, the degree of carotid atherosclerosis in the observation group was significantly reduced after 6 and 12 courses of treatment ( Z=-2.12, P<0.05; Z=-2.89, P<0.05); compared with those in the control group after 6 and 12 courses of treatment, the degrees of carotid atherosclerosis at the same time points in the observation group were also significantly reduced ( Z=-2.01, P<0.05; Z=-2.58, P<0.05). Compared with that before treatment, the degree of carotid stenosis in the observation group was significantly reduced after 3 and 6 courses of treatment ( Z=-2.17, P<0.05; Z=-2.34, P<0.05); compared with those in the control group after 6 and 12 courses of treatment, the degrees of carotid stenosis in the observation group were also significantly reduced ( Z=-2.00, P<0.05; Z=-2.17, P<0.05). Compared with those before treatment, the plaque thickness, the long diameter of plaque, and IMT in the observation group were decreased significantly after 6 and 12 courses of treatment ( P<0.05); compared with those in the control group at each time point of treatment, the plaque thickness, long diameter, and IMT in the observation group were decreased significantly ( P<0.05). Compared with those before treatment, the levels of CRP, MMP-9, ET, and Hcy in the observation group were decreased significantly after 2 and 4 courses of treatment ( P<0.05); compared with those in the control group at each time point of treatment, the levels of CRP, MMP-9, ET, and Hcy in the observation group were also decreased significantly ( P<0.05). Conclusion:Different courses of HBO combined with statins can improve the degree of carotid atherosclerosis and stenosis in patients with ACI, and turn vulnerable plaque into stable plaque. In addition, CRP and MMP-9 may be the potential serum markers expressing the stability of vulnerable plaques, and the stability is related to the levels of ET and Hcy after treatment.
