Hyperbaric oxygen combined with cilostazol in the treatment of delayed cerebral vasospasm after aSAH
Shao Shuai
Zhang Ningning
Zheng Feiyu
Abstract：Objective To observe the effect of hyperbaric oxygen combined with cilostazol in the treatment of delayed cerebral vasospasm after aneurysmal subarachnoid haemorrhage(aSAH).Methods Ninety patients with delayed cerebral vasospasm after aSAH admitted to our hospital from September 2020 to December 2023 were selected as the study subjects and were randomly divided into two groups using the envelope method.Both groups were treated with conventional symptomatic treatment,the conventional group(n=45)was given cilostazol treatment,and the hyperbaric oxygen group(n=45)was given hyperbaric oxygen treatment on the basis of the conventional group.The haemodynamic and endothelial function indexes of the middle cerebral artery,high mobility group protein 1(HMGB1)/Toll-like receptor 4(TLR4)signaling pathway factors,microRNA-210(miR-210),high sensitivity-C-reactive protein(hs-CRP),and tumour necrosis factor-alpha(TNF-alpha)were examined in the two groups,and the levels of the NIH Stroke Scale(NIHSS)and the National Institutes of Health Stroke Scale(NIHSS)were assessed in the two groups.Stroke Scale(NIHSS)score differences between the two groups.Results After treatment,the mean blood flow velocity(Vm),the peak systolic flow velocity(PSV),and the resistance index(RI)in the conventional group and hyperbaric oxygen group were statistically significant(t=2.763,5.554,4.964,P＜0.05).The calcitonin gene-related peptide(CGRP),nitric oxide(NO),and miR-210 in the hyperbaric group were higher than the conventional group(t=5.062,7.300,2.290;P＜0.05).The soluble lectin-like oxidised low-density lipoprotein receptor-1(sLOX-1),endothelin-1(ET-1),hs-CRP,and TNF-α in the Hyperbaric oxygen group were lower than the conventional group(t=2.788,5.153,7.198,2.558;P＜0.05).After treatment,the HMGB1,and TLR4 in the hyperbaric oxygen group were lower than the conventional group(t=3.727,7.939;P＜0.05).After treatment,the NIHSS scores in the conventional group were lower than those in the conventional group(t=4.532;P＜0.05).Conclusion Hyperbaric oxygen combined with cilostazol for the treatment of delayed cerebral vasospasm after aSAH reduces neurological impairment.
Keywords：Hyperbaric oxygenCilostazolAneurysmal subarachnoid haemorrhageDelayed cerebral vasospasmVascular endothelial functionInflammatory factors
Publication Date：2025-08-31
Online Publishing Date：2025-09-24(First online date of this platform, not the publication date of the document)
Pages：4( 640-643 )