亚低温对重型脑损伤后血清IL-1β和S-100β蛋白含量的影响  

Influence of mild hypothermia on serum protein levels of IL-1β and S-100β in patients with severe traumatic brain injury

作　　者：范学政[1,2] 周开宇[1] 潘红日[1] 金涌[1] 姜军合[1] 毛天明[1] 金杭煌[1] 王广涛[1] 

机构地区：[1]复旦大学附属华山医院台州分院神经外科,台州318000 [2]绵阳市404医院神经医学中心,621000

出　　处：《中华创伤杂志》2007年第1期34-37,共4页Chinese Journal of Trauma

摘　　要：目的 观察重型创伤性脑损伤（severe traumatic brain injury，sTBI）患者血清IL-1β和S-100β蛋白含量变化以及亚低温治疗对IL-1β和S-100β蛋白含量的影响，探讨亚低温脑保护的可能机制。方法 46例sTBI患者随机分成常温治疗（normothermia-treated，NT）组和亚低温治疗（mild hypothermia-treated，HT）组，分别予以常温治疗和亚低温治疗。两组均于伤后6，24h、3，8d等各时间点采用酶联免疫吸附（ELISA）法测定IL-1β和S-100β蛋白含量；分析各时间点两组IL-1β和S-100β蛋白含量与GCS的相关性。结果 （1）伤后各时间点两组sTBI患者血清IL-1β和S-100β蛋白含量明显高于对照组（P〈0．01），但两组间IL-1β和S-100β蛋白含量在伤后6h差异无统计学意义（P〉0．05）。（2）亚低温治疗后各时间点HT组IL-1β和S-100β蛋白含量低于NT组（P（0．01）。（3）NT组于伤后各时间点IL-1β和S-100β蛋白含量均与GCS呈负相关；HT组IL-1β和S-100β蛋白含量于伤后24h、3d与GCS无相关性，6h、8d与GCS呈负相关；与NT组比较，出院时HT组预后较好。结论 亚低温治疗能够降低sTBI患者IL-1β与S-100β蛋白含量，改善预后，具有脑保护作用。其脑保护机制可能与亚低温能减轻血清IL-1β和S-100β蛋白介导的损伤性脑细胞炎症反应有关。Objective To disclose the probably protective mechanism of mild hypothermia protecting brain through investigating the protein content changes of IL-1β and S-100β in serum in patients with severe traumatic brain injury （sTBI） and the influence of mild hypothermia on protein contents of IL-1β and S-100β. Methods A total of 46 cases with sTBI were treated with normothermia （NT） （NT group, n =23） and mild hypothermia （HT） （HT group, n =23）, respectively. Ten healthy adults were taken as control group. ELISA was used to measure serum protein levels of IL-1β and S-100β in two groups at 6, 24 hours, 3 and 8 days respectively after injury. Then, the relationship between serum protein levels of IL-1β and S-100β at different time points and GCS was analyzed. Results （ 1 ） At each time point, serum protein levels of IL-1β and S-100β in NT group and HT group were statistically higher than that of the control group （P 〈 0.01 ）, with insignificant difference at 6 hours after sTBI upon serum protein levels of IL-1β and S-100β in NT group and HT group （P 〉 0.05）. （2） Serum protein levels of IL-1β and S-100β in HT group were lower than that of NT group after HT （P 〈 0.01 ）. （3） At each time point, GCS was negatively correlated with serum protein levels of IL-1β and S-100β in NT group. In HT group, serum protein levels of IL-1β and S-100β were negatively correlated with GCS at 6 hours and 8 days but had no correlation with GCS at 24 hours and 3 days. HT group had better outcome at dischargement, compared with NT group. Conclusion Mild hypothermia can decrease serum protein levels of IL-1βand S-100β, improve prognosis and protect the injured brain in cases with sTBI, which may be related to its abating the inflammatory reaction of brain cells mediated by serum proteins IL-1β and S-100β.

关 键 词：脑损伤 重型 亚低温 白细胞介素-1Β S-100Β蛋白 

分 类 号：R686[医药卫生—骨科学]