Objective To investigate the effects of hyperbaric oxygen(HBO)on the rehabilitation of nervous function and expression of Toll-like receptor4(TLR-4)mRNA on peripheral blood mononuclear cells (PBMCs)in serum in patients with acute cerebral infarc-tion.Methods The 58 patients with acute cerebral infarction were randomized into control group and HBO group.All patients were undergoing conventional medical treatment,and HBO group also received HBO therapy.In addition,25 health controls were included. The expression of TLR-4 mRNA on PBMCs from 80 patients were measured by real time quantitative RT-PCR before and on the 5th , 10th day of HBO treatment.The National Institutes of Health stroke scale(NIHSS)and the Barthel index(BI)were also used for eval-uation before and on the 5th,10th day of HBO treatment,and 21st day after onset.Results The expression of TLR-4 on PBMCs in pa-tients with acute cerebral infarction was significantly increased compared to health controls (P <0.01)on the onset.After treatment, it declined,and HBO group was significantly lower than control group. On the 10th day of treatment,and 21st day after onset,in HBO group,NIHSS scores were significantly lower while BI scores were significantly higher than control group(P <0.01).Conclusions The expression of TLR-4 mRNA on PBMCs of acute cerebral patients can be significantly depressed by HBO therapy,which decreases inflammatory reaction secondary to cerebral injury,promotes rehabilitation of nervous function and improves the outcome.%目的：观察高压氧治疗对于急性脑梗死患者外周血单核细胞（PBMCs）Toll 样受体4（TLR-4）mRNA 的表达及神经功能康复的影响。方法入选58例脑梗死患者，随机分为对照组和高压氧治疗组，两组患者均予常规药物治疗，高压氧治疗组在常规治疗基础上予以高压氧治疗。另入选25例健康体检者为健康对照组（正常组），高压氧治疗前、治疗第5、10天分离两组患者 PBMCs，荧光定量 RT-PCR 法检测 TLR-4mRNA 表达。高压氧治疗前、治疗第5、10天及起病21 d 患者随访进行美国国立卫生院神经功能缺损评分（NIHSS）及日常生活能力（ADL）评分。结果脑梗死患者（对照组，高压氧治疗组）起病时外周血单核细胞 TLR-4mRNA 的表达均显著高于正常组，治疗后两组患者外周血 TLR-4mRNA 表达均下降，高压氧治疗组显著低于对照组。高压氧治疗组治疗第10天及起病21 d 后 NIHSS 评分均显著低于对照组，ADL 评分则高于对照组。结论高压氧治疗显著降低急性脑梗死患者外周血 TLR-4mRNA 的表达，减轻脑损伤后继发性炎症反应，促进神经功能的恢复，改善预后。
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