Clinical Study On Ozone Treatment Of Acute Large Cerebral Infarction

Background and Purpose:The massive cerebral infarction has big lesions, serious cerebral edema, mostlyacross the lobes of the brain distribution, and easily lead to brain herniation and otheradverse consequences. The head imaging lesion volumes in the acute phase aresignificantly associated with the prognosis of patients with cerebral infarction, and isan independent predictor. The diagnosis of cerebral infarction is mainly based onclinical manifestations and imaging, and the medical management mostly includeddehydration reducing the intracranial pressure, antithrombotic therapy, improvingcirculation, nutrition, and so on. Ozone therapy has been widely used in the medicalfield, and is effective and relatively safe with rare complications. Ozone in thetreatment of cerebral infarction have been reported, the efficacy is still need for furtherverification.In this study, the ozone therapy with the blood transfusion was used into treatmentof the patients with massive cerebral infarction, through the comparison of before andafter treatment of clinical indicators, including blood cell counts, blood lipids, glucose,fibrinogen, cerebral infarc volume, NIHSS score and EEG impedance values，withMedical therapy as the control group, to explore the efficacy of ozone therapy inpatients with massive cerebral infarction.Subjects and Methods:This study was performed during the period of March2011to March2012in theDepartment of Neurology, Shenyang Military General Hospital. A prospective,controlled clinical study design was adopted. The30patients with intact data wereenrolled in the study analysis.22males and8females, aged41to80years with anaverage of65.3years. The including criteria of massive cerebral infarctionrecommanded by China Cerebrovascular Disease Prevention and Treatment Guidelines was used in this study: infarc lesion more than one lobes of the brain, or the maximumdiameter of the cross-sectional area≥5cm. The infarction lesions were localized in thedominated areas of the internal carotid artery or the middle cerebral artery infarction,and NIHSS score were more than14points. Enrolled patients were divided into threegroups:(1) control group:10cases, only the use of medication;(2) ozone treatmentgroup1:10cases,5-day course of ozone therapy in addition to drug therapy;(3) ozonetreatment group2:10cases,10-day course of ozone therapy in addition to drug therapy.The start treatment time: after the onset of40minutes to3days with an average of1.3days. The medical records were reviewed including blood cell counts, lipids, glucose,fibrinogen, as well as head imaging data. The infarc volumes, NIHSS scores and thebrain electric impedance values (Model BORN-BE-II, Chongqing Bohn TechnologyCo., Ltd.) were calculated. The correlationThe above-mentioned indicators before and after treatment in each group werecompared for statistical analysis.Results:1. Fibrinogen (Fib) level and NIHSS score: Three sets of ozone-treated patients,the Fib leval and NIHSS scores in three groups after treatment were significantlyreduced (p<0.05), and differences among them were of statisticall significance.2. Blood cell counts, sugar and lipids: The blood cell (WBC, RBC, Hb, PLT)counts and glucose were unchangeed in three groups before and after treatments (p>0.05). The total cholesterol, triglycerides, low-density lipoprotein were reduced amongthree groups with the significant differences (p <0.01).3. Infarct volume: The infarct volumes calculated on head CT or MRI weresignificantly reduced (p <0.05) after10to14days after treatment, but the differencesamong three groups were not obvous (p>0.05).4. Cerebral electreic impedance (CEI) value: The CEI values in patients withmassive infarction were increased24h of the onset, the CEI values at infarction sidehigher than non-infarction side, and were of the down-ward tendency. After14d-periodof treatment, CEI values of the infarction side in ozone treatment group2weresignificantly reduced, and were lower than not only in same group after the onset of5dand10d (p <0.05), but also in the ozone treatment group1and the control group (p<0.05).5. Multivariate Logistic Regression: Multivariate Logistic regression analysis demonstrated that the three variables including fibrinogen level, NIHSS score, CEIvalues in the infarction side were significantly correlated with ozone therapy (p <0.05).Conclusion:Ozone therapy with the blood transfusion can significantly lower blood lipids andfibrinogen, reduce the brain edema and improve the prognosis especially for patientswith massive cerebral infarction, Therefore, ozone therapy should be as auxiliarytreatment as early as possible in treatment of cerebral infarction.