Efficacy of hyperbaric oxygen combined with dual antiplatelet therapy in elderly patients with acute cerebral infarction and its impact on nerve factors

高压氧联合双重抗血小板治疗对老年急性脑梗死患者的疗效及其对神经因素的影响

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Abstract

OBJECTIVE: We aimed to ascertain the efficacy of hyperbaric oxygen therapy (HBOT) combined with dual antiplatelet therapy (DAPT) in elderly patients with acute cerebral infarction (ACI) and its impact on nerve factors. METHODS: A total of 122 patients were randomly assigned (1:1) to either the observation group or the control group. Patients in the control group received DAPT, And those in the observation group received HBOT combined with DAPT. Treatment was administered in 3 consecutive daily sessions starting from the date of admission. All patients were evaluated for efficacy after treatment. Before and after treatment, the National Institutes of Health Stroke Scale (NIHSS), and the Chinese Stroke Scale (CSS) were assessed; the levels of serum neuron-specific enolase (NSE) and plasma β-amyloid-42 (Aβ-42), hemorheology indices (whole blood viscosity and plasma viscosity), coagulation indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and fibrinogen (Fbg)], and inflammatory factor [matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), and C-reactive protein (CRP)] were measured; the Barthel Index (BI) scores were recorded. RESULTS: After treatment, the observation group exhibited higher total effective rate, longer APTT, PT and TT, and higher BI score compared to the control group (all P < 0.05), while lower NIHSS, CSS scores, lower levels of NSE, Aβ-42, and Fbg, lower whole blood viscosity, plasma viscosity, MMP-9, IL-6 and CRP compared to the control group (all P < 0.05). CONCLUSION: HBOT combined with DAPT can enhance efficacy, ameliorate neurologic impairments, enhance the effect of thrombolysis, reduce inflammatory response, and improve activities of daily living in elderly patients with ACI.

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