臭氧治疗对急性期脑梗塞血清谷氨酸浓度的影响研究

发布时间：2018-11-26 14:28

【摘要】：目的：通过临床观察臭氧（O3）治疗对急性期脑梗塞患者血清中谷氨酸（GLU）水平的影响，探讨其对急性期脑梗塞的疗效及对预后的影响，为臭氧（O3）治疗在脑血管疾病上的临床应用提供理论依据，并验证兴奋性氨基酸是与临床疗效一致的化验指标，且其数值可反映急性期脑梗塞的患者病情的缓急轻重，并对其作以分析探讨。方法：将于2012.8-2013.1期间沈阳市第二中医院救治的急性脑梗塞的患者，根据患者的脑梗塞部位，面积，发病时间等筛选60例并分组。治疗组（应用臭氧自体血回输治疗30例）和对照组（常规药物治疗30例),两组均于发病72h内接受治疗。对照组采用脱水降颅压，控制血压，应用脑细胞保护剂等常规药物治疗,治疗组在常规疗法基础上加用臭氧自体血回输治疗，用专用采血袋，取患者肘正中静脉，采血100毫升，与浓度为47μg/ml的医用臭氧100ml，按1：1比例混合，经过5-10分钟，，与血液充分混合后，15分钟内回输至患者体内，每日一次，14天为一个疗程。入组后1天，3天，7天，14天检测采用分光光度法测定血浆谷氨酸水平，以及进行相关疗效评判，并对记录之结果行统计学分析。结果： 1.临床表现应用臭氧自体血回输治疗14天后，治疗组与对照组比，神经功能缺损评分明显降低，差异有显著性意义(P0.05)；证实治疗组神经功能恢复良好，优于对照组。另外，患者经治后，半身不遂、口眼歪斜、舌强言蹇或不语等临床症状好转情况，治疗组更为明显。 2.理化检查应用臭氧自体血回输治疗14天后，治疗组与对照组对比，治疗组血浆谷氨酸明显低于对照组，差异有显著性意义(P0.05或P0.01)。 3.整体疗效治疗后，采用《中国神经功能缺损评定标准》[2]进行评分，行疗效评判。其中，对照组基本治愈1例，显著进步7例，进步13例，无效9例，总有效率70.00%，治疗组基本治愈4例，显著进步12例，进步9例，无效5例，总有效率83.33%，经统计分析证实，治疗组疗效明显优于对照组，差异有统计学意义(P＜0.05)。结论：采用臭氧自体血回输治疗同时检测血清兴奋性氨基酸水平，对急性期脑梗塞的临床疗效确实，既可促进神经功能尽快恢复，又可提示预后水平。兴奋性氨基酸是与脑梗塞的临床疗效一致的化验指标，且其数值标志着患者病情缓急轻重。臭氧治疗其机制之一可能与降低血浆兴奋性氨基酸水平有关。
[Abstract]:Objective: to observe the effect of ozone (O3) treatment on serum glutamate (GLU) level in patients with acute cerebral infarction, and to explore its effect on acute cerebral infarction and its influence on prognosis. To provide a theoretical basis for the clinical application of ozone (O3) in the treatment of cerebrovascular diseases, and to verify that the excitatory amino acid is the same as the clinical efficacy, and its value can reflect the severity of the patients with acute cerebral infarction. It is analyzed and discussed. Methods: 60 patients with acute cerebral infarction who were treated in Shenyang second traditional Chinese Medicine Hospital from 2018 to 2013.1 were selected and divided according to the location, area and time of onset of cerebral infarction. The treatment group (30 cases were treated with ozone autologous blood transfusion) and the control group (30 cases with routine drug therapy) were treated within 72 hours after the onset of the disease. The control group was treated with dehydration, blood pressure control, brain cell protectant and other routine drugs. The treatment group was treated with ozone autologous blood transfusion on the basis of routine therapy. 100 ml of medical ozone was mixed with 47 渭 g/ml of medical ozone at 1:1. After 5 to 10 minutes of mixing with blood, it was infused to the patients within 15 minutes, once a day, 14 days as a course of treatment. The plasma glutamate levels were measured by spectrophotometry on day 1, day 3, day 7 and day 14 after admission, and the results were analyzed statistically. Results: 1. After 14 days of ozone autologous blood transfusion, the neurological deficit score in the treatment group was significantly lower than that in the control group (P0.05). It was proved that the nerve function of the treatment group was better than that of the control group. In addition, the patients after treatment, hemiplegia, mouth and eye skew, tongue-strong or silent and other clinical symptoms improved, the treatment group was more obvious. 2. After 14 days of ozone autologous blood transfusion, compared with the control group, the plasma glutamate in the treatment group was significantly lower than that in the control group (P0.05 or P0.01). 3. After the whole treatment, the evaluation standard of Chinese nerve function defect [2] was used to evaluate the curative effect. In the control group, 1 case was basically cured, 7 cases were improved significantly, 13 cases were improved, 9 cases were ineffective, and the total effective rate was 70.000.In the treatment group, 4 cases were cured, 12 cases were improved significantly, 9 cases were improved, 5 cases were ineffective, and the total effective rate was 83.33%. Statistical analysis showed that the curative effect of the treatment group was significantly better than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: the level of serum excitatory amino acids in patients with acute cerebral infarction treated by ozone autologous blood transfusion can not only promote the recovery of nerve function, but also indicate the level of prognosis. Excitatory amino acid is the same as the clinical efficacy of cerebral infarction, and its value indicates the patient's disease priority. One of the mechanisms of ozone therapy may be related to the reduction of plasma excitatory amino acid levels.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.33

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