局部亚低温对急性脑出血患者血中神经元特异性烯醇化酶及超敏C反应蛋白的影响及临床意义  

Influence and clinical significance of local mild-hypothermia therapy on serum levels of NSE and hsCRP in patients with acute cerebral hemorrhage

作　　者：郑坤木[1] 童绥君[1] 马琪林[1] 

机构地区：[1]福建医科大学附属厦门第一医院神经内科,厦门361003

出　　处：《中国实用神经疾病杂志》2009年第10期1-4,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究局部亚低温对急性脑出血患者血中神经元特异性烯醇化酶(neuron-specific enolase,NSE)及超敏C反应蛋白(high sensitivity C-reactive protein,hsCRP)的影响,探讨局部亚低温治疗脑出血的临床意义和机制。方法将急性脑出血患者36例随机分为局部亚低温组19例和甘露醇等常规治疗组17例。局部亚低温组在甘露醇等常规治疗基础上给予病灶侧局部亚低温治疗72h。对照组为40例健康体检者。动态监测脑出血患者入院时及第3、7、14天血中NSE、hsCRP的浓度,并对患者的临床结果行美国国立卫生研究院卒中量表(NIHSS)评分。结果脑出血患者血中NSE、hsCRP的水平均升高,与常规治疗相比,NSE水平在第7天和第14天局部亚低温组明显低于常规治疗组(P<0.05),而hsCRP水平在第14天局部亚低温组明显低于常规治疗组(P<0.05)。NIHSS评分在第14和21天局部亚低温组明显低于常规治疗组(P<0.05)。结论局部亚低温治疗可显著降低脑出血患者血液hsCRP及NSE水平,抑制脑出血炎症反应,减轻神经损伤,保护和改善急性脑出血神经功能。Objective To study the influence of focal mild hypothermia on the changes of blood neuron-specific enolase （NSE） and high sensitivity C-reactive protein （hsCRP） in patients with acute cerebral hemorrhage and their clinical significance and mechanism. Methods Thirty-six patients with acute cerebral hemorrhage were randomly divided into two groups of the local mild hypothermia and routine therapy with mannitol. The former group and the latter group were 17 cases and 19 cases respectively and the latter group was treated for 72h based on routine therapy. The control group was 40 healthy subjects. Serum levels of NSE and hsCRP were determined and the clinical status was evaluated by NIHSS dynamically before treatment and at 3rd,7th and 14th day after the treatment. Results The blood levels of NSE and hsCRP in patients with acute cerebral hemorrhage were higher than the normal levels. Contrast to routine therapy group,the levels of NSE were significantly decreased in local mild hypothermia group at 7th and 14th day after the treatment （P〈0.05）, and the levels of hsCRP were significantly decreased in local mild hypothermia group at 14th day after the treatment （P〈0.05）, and the NIHSS score＇was apparently improved at 14th and 21th day after the treatment （P〈0.05）. Conclusion The local mild hypothermia therapy could dramatically reduce the blood level of NSE and hsCRP, inhibit inflammatory reaction,alleviate the severity of the damaged neurons, protect and improve neurological function in patients with acute cerebral hemorrhage.

关 键 词：急性脑出血 局部亚低温 神经元特异性烯醇化酶 超敏C反应蛋白 

分 类 号：R743.34[医药卫生—神经病学与精神病学]