亚低温治疗对重型颅脑损伤患者血中神经元特异性烯醇化酶的影响及其临床意义  

Influence and clinical significance of mild hypothermia therapy on serum levels of neuron specific enolase (NSE) in the patients following severe brain injury

作　　者：池京洋[1] 只达石[1] 黄楹[1] 黄慧玲[1] 曹德晨[1] 张晓东[1] 张国哲[1] 

机构地区：[1]天津医科大学神经外科,天津300070

出　　处：《中国急救医学》2006年第10期659-660,共2页Chinese Journal of Critical Care Medicine

摘　　要：目的观察亚低温治疗后重型颅脑损伤患者血中神经元特异性烯醇化酶(NSE)的动态变化,为评价亚低温的脑保护作用提供量化指标。方法45例重型颅脑损伤患者被随机分为亚低温治疗组(22例)和常温治疗组(23例),脑温分别控制在(34．2±0．2)℃和(36．9±0．3)℃。动态监测患者治疗前及治疗后24、48、72、96 h血中NSE变化,并于3个月后对患者预后进行评估。结果亚低温治疗组患者血中NSE浓度在治疗后24、48、72 h显著降低．3个月后预后显著改善。结论亚低温治疗可以减轻神经元损伤,显著抑制NSE释放,增强神经元对脑外伤的耐受性,对重型颅脑损伤患者具有保护作用。Objective To observe the effects of mild hypothermia therapy on the dynamic change of neuron specific enolase （NSE ） in the serum of patients following severe brain injury and to provide a quantitative parameter to evaluate the protective effect of mild hypothermia on injured brain. Methods 45 patients following severe brain injury were randomly divided into mild hypothermia group 122 cases ） and normothermia group （23cases ）, the brain temperature was controlled between 134.2 ＋ 0.2 ）℃ and （36.9 ＋ 0. 3 ）℃ respectively. Serum levels of NSE were determined with radio - immunoassay I RIA） dynamically before treatment and 24 , 48 , 72 and 96 hours after the treatment. The outcome was evaluated according to Glasgow Coma Scale 3 months after the treatment. Results The serum levels of NSE were significantly decreased in mild hypothermia group at the early stage of treatment and the out- come was apparently improved 3 months later. Conclusions The mild hypothermia therapy could dramatically alleviate the severity of the damaged neurons, inhibit the release of NSE and enhance the endurance of neurons to brain injury, and has a protective effects on the patients following severe brain injury.

关 键 词：重型颅脑损伤 亚低温 常温 神经元特异性烯醇化酶 

分 类 号：R651.15[医药卫生—外科学]