Normobaric Hyperoxia in Patients With Acute Stroke: Enhancing Neuroprotection Through Inhibition of Inflammation.

IF 5.3 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Heart Association Pub Date : 2025-10-09 DOI:10.1161/JAHA.125.041825

Hongmei Niu, Jiayue Ding, Zhiying Chen, Shuhua Yuan, Zhifeng Qi, Xunming Ji, Weili Li

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Abstract

Background: Inflammatory response is an important pathological and physiological mechanism in the occurrence and development of acute ischemic stroke. This study investigated the effects of normobaric hyperoxia on the inflammatory response in acute ischemic stroke and explored the role of inflammation in stroke-induced brain injury.

Methods: This secondary analysis of the OPENS (Normobaric Hyperoxia Combined With Reperfusion for Acute Ischemic Stroke) trial, included 86 acute ischemic stroke patients with anterior circulation large vessel occlusion: 43 received normobaric hyperoxia (10 L/min, 100% oxygen for 4 hours) with endovascular thrombectomy, and 43 received endovascular thrombectomy alone. Inflammatory markers were measured at different time points (admission, 24 hours, 7 days), and National Institutes of Health Stroke Scale score and cerebral infarction volume were also recorded. The main outcome measures were serum CRP (C-reactive protein) levels, peripheral blood leukocyte count, neutrophil count, and neutrophil-to-lymphocyte ratio. Correlation analysis was used to analyze the relationship between inflammatory markers and stroke.

Results: The results showed that the normobaric hyperoxia group had significantly lower levels of inflammatory markers compared with the control group at 24 hours (P<0.05). Early correlation analysis (within 24 hours) showed a significant positive association between 24-hour inflammatory marker levels and early neurological function scores (National Institutes of Health Stroke Scale) as well as early infarct volume (assessed at 24-48 hours).

Conclusions: Normobaric hyperoxia attenuates early postthrombectomy inflammation, as evidenced by reduced CRP, neutrophil counts, and neutrophil-to-lymphocyte ratio. These inflammation markers were significantly associated with acute stroke severity and infarct volume.

Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT03620370.

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急性脑卒中患者的常压高氧：通过抑制炎症增强神经保护。

背景：炎症反应是急性缺血性脑卒中发生发展的重要病理生理机制。本研究探讨了常压高氧对急性缺血性脑卒中炎症反应的影响，探讨炎症在脑卒中脑损伤中的作用。方法：对open（常压高氧联合再灌注治疗急性缺血性卒中）试验进行二次分析，纳入86例急性缺血性卒中前循环大血管闭塞患者：43例接受常压高氧（10 L/min， 100%供氧4小时）联合血管内取栓，43例单独接受血管内取栓。在不同时间点（入院、24小时、7天）测量炎症标志物，并记录美国国立卫生研究院卒中量表评分和脑梗死体积。主要结局指标为血清CRP （c反应蛋白）水平、外周血白细胞计数、中性粒细胞计数和中性粒细胞与淋巴细胞比值。采用相关分析分析炎症指标与脑卒中的关系。结果：结果显示，与对照组相比，常压高氧组在24小时内炎症标志物水平显著降低(p结论：常压高氧可减轻血栓切除术后早期炎症，这可以通过降低CRP、中性粒细胞计数和中性粒细胞与淋巴细胞比值来证明。这些炎症标志物与急性卒中严重程度和梗死体积显著相关。注册：网址：https://www.clinicaltrials.gov；唯一标识符：NCT03620370。

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来源期刊

Journal of the American Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

1.90%

发文量

1749

审稿时长

12 weeks

期刊介绍： As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice. JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.