研究報告指出高壓氧對於腦中風病人有保護的作用，而高壓氧亦會促進骨髓幹細胞的增生並移動到缺氧而損傷的組織。 本實驗目的在探討使用高壓氧治療腦中風後骨髓幹細胞被召集到腦組織的情況，以及神經細胞新生、膠質細胞增生、血管上皮細胞新生和調節發炎反應的狀況。
大鼠以中大腦動脈阻塞模擬中風產生，之後分別進行為期三週十五次的高壓氧治療，以及兩天兩次的高壓氧治療。並使用修改的神經學損傷嚴重程度評分表(mNSS)來做為行為學上的評量以評估預後情形，以及利用不同種類的免疫組織染色法(CD34-DAPI, BrdU-NeuN, BrdU-GFAP, BrdU-RECA-1, and DAPI-MPO)來觀察腦組織切片，探討高壓氧是否會影響骨髓幹細胞的移行以及是否會影響神經細胞新生、膠質細胞增生、血管上皮細胞新生、神經滋養物質的產生和調節發炎反應的情形。實驗結果發現，在大鼠以中大腦阻塞引發的暫時性腦中風為模型下, 高壓氧治療可以調節腦中風後所引起的傷害。在以三週高壓氧為治療週期的組別中可觀察較低的神經損傷嚴重程度分數(第二十一天 分數為6.2)；而只有兩天高壓氧治療的組別損傷嚴重程度分數較高(第二十一天,分數為9.75)。 這意味著三週的高壓氧治療療程比只有兩天高壓氧治療有著較好的神經學上的改善。而較長時間的高壓氧治療也會使得較多的骨髓幹細胞聚集到損傷的腦組織，因此治療時間長短是重要因素。此外，高壓氧治療會有較多程度的神經細胞新生、膠質細胞增生、血管上皮細胞新生及神經滋養物質的產生，並減少中性球聚集到損傷的腦組織進而調節發炎的反應。
結論是高壓氧在腦中風的治療會促進神經保護修補。此外，治療時間若由兩天延長到三週更可以增加治療的效果。

關鍵字：骨髓幹細胞、高壓氧治療、中風

Several studies have provided evidence about neuroprotection by hyperbaric oxygen (HBO) therapy in stroke cases. HBO also promotes bone marrow stem cells (BMSCs) proliferation and mobilization. The study investigates the influence of HBO therapy on migration of BMSCs, neurogenesis, gliosis, angiogenesis and inflammation after transient ischemic stroke.
Rats that sustained one hour of transient middle cerebral artery occlusion (MCAO) were treated with HBO 15 times within 3 weeks or HBO two times within two days. The results were examined using a behavior test (modified neurological severity score, mNSS) and immunohistochemistry staining on CD34-DAPI, BrdU-NeuN, BrdU-GFAP, BrdU-RECA-1, and DAPI-MPO were used to evaluate the effects of HBO therapy on migration of bone marrow stem cells, neurogenesis and gliosis, angiogenesis and inflammation as well as expression of neurotrophic factors were also evaluated.
HBO significantly attenuated ischemic injury of transient MCAO. There was lower mNSS score in the three weeks HBO group (6.2 in day 21), comparing with two days HBO group (9.75 in day 21). It explained that three weeks of HBO treatment had a significantly better neurological outcome than two days HBO course, suggesting the dose-dependent effect of HBO therapy. Mobilization of BMSCs to ischemic area was more improved in long course HBO treatments but not by short course treatments, suggesting that the duration of therapy is crucial for promoting the homing of BMSCs to ischemic brain by HBO therapies. HBO also can stimulate expression of trophic factors and improve neurogenesis , gliosis and angiogenesis. HBO can also decreased the effect of neutrophil aggregation then attenuated inflammation.These effects may help neuronal repair after ischemic stroke and increasing the course of HBO therapy from 2 days to 3 weeks might enhance therapeutic effects on ischemic stroke.

Key word: Bone marrow stem cells; hyperbaric oxygen treatment; stroke

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