The Effect Of Hyperbaric Oxygenation (HBO) Therapy On The Levels Of Serum SICAM-1 And SVCAM-1 In Patients With Acute Cerebral Infarction

Objective To characterize the effect of hyperbaric oxygenation(HBO) therapy on the levels of serum soluble intercellular adhesion molecule-l(sICAM-l), soluble vascular cell adhesion molecule-1(sVCAM-l) in patients with acute cerebral infarction(ACI) and their clinical significance.Methods 100 cases of acute cerebral infarction were divided into two groups, the hyperbaric oxygen treatment group(HBO group, 50 cases) and the conventional treatment group(50 cases). HBO group was treated with HBO therapy combined with clinical conventional treatment;the conventional treatment group was treated with clinical conventional treatment only. 20 healthy persons were used as control subjects. The levels of serum sICAM-1 and sVCAM-1 in the patients were measured by ELISA at 1 day, 7 days and 14 days after hospitalization. Computed tomography(CT) scan or MRI were performed within 3 days, and the infarct volume and infarct location were recorded. The clinical neurological deficit scores in patients with ACI were evaluated at 1 day and 14 days after hospitalization. All the parameters of the two ACI groups were compared and the therapeutic effects were evaluated.Results 1. There were no significant difference between HBO group and conventional group in the levels of serum sICAM-1 and sVCAM-1 at 1 day after hospitalization. The levels of serum sICAM-1 and sVCAM-1 in the two ACI groups were obviously higher than that in the healthy controls(P<0.01). At 7 days and 14 days after hospitalization, the levels of serum sICAM-l,sVCAM-l in HBO group were significantly lower than that in the conventional group(P<0.01). The levels of serum sICAM-land sVCAM-1 in each ACI group decreased gradually with time going (p<0. 05) . 2. There were no significant difference between HBO group and conventional group with different sizes of infarct volum in the levels of serum sICAM-1 and sVCAM-1 at 1 day after hospitalization (P>0.05) . At 7days after hospitalization, the levels of serum sICAM-1 and sVCAM-1 in the large infarct group have no obvious difference between HBO group and conventional group (P>0.05) , whereas the levels of serum sICAM-1 and sVCAM-1 in the medium and the small infarct subgroup of HBO group were lower than that of the conventional group, (P<0.01). At 14 days after hospitalization, the levels of serum sICAM-1 and sVCAM-1 in HBO group with different infarct volum were dramatically lower than that in the conventional group with corresponding infarct volume (P<0.01). 3.At 14days after hospitalization, the neurological function deficiency scores of HBO group were much less than that of the conventional group. Clinical effective rate in HBO group was obviously higher than that in the conventional group(94.0%vs82. 0%, P < 0.05).Conclusions 1. The levels of serum sICAM-l,sVCAM-l in ACI patients may be the indicators of the severity of the diseases. 2.HBO therapy can decrease the levels of serum sICAM-1 and sVCAM-1 in ACI patients, inhibit the expression of adhesion molecules and reduce the extent of the inflammatory injury in the course of cerebral ischemia. 3. HBO therapy can lessen the infarction volume in ACI patients and reduce cerebral injury. 4. HBO therapy can accelerate the recovery of neurological function of ACI patients, improve the clinical efficacy, and therefore HBO therapy may be one of the effective approaches in the treatment of ischemic cerebral infarction.