亚低温对重型颅脑创伤患者血清抗脑抗体含量的影响  

The influence of mild hypothermia on ABAb in serum in patients with sTBI

作　　者：范广明[1] 张文彬[1] 张赛[1] 

机构地区：[1]武警医学院附属医院脑系科,天津300162

出　　处：《中华神经外科杂志》2011年第6期703-705,共3页Chinese Journal of Neurosurgery

摘　　要：目的 研究重型颅脑创伤（sTBI）后患者血清抗脑抗体（ABAb）浓度变化及亚低温治疗对血清ABAb浓度的影响，探讨亚低温脑保护机制。方法选择80例sTBI住院患者，随机分成常温治疗（NT）组和亚低温治疗（HT）组各40例，分别予以常温治疗和亚低温治疗，于伤后第1、3、5、7、14天采血，用酶联免疫吸附（ELISA）法测定血清ABAb浓度，观察各时间点血清ABAb浓度的变化，分析各时间点两组血清ABAb浓度与格拉斯哥预后评分（GOS）的相关性。另取20例健康体检者作为对照组。结果（1）所有sTBI患者在伤后各时间点血清ABAb浓度高于正常对照组（P〈0．01）。（2）HT组于伤后各时间点血清ABAb浓度低于NT组，且差异有统计学意义（P〈0．01）。（3）NT组于伤后各时间点血清ABAb浓度与GOS评分呈负相关，出院时HT组预后也较NT组为佳。结论HT能够降低sTBI患者血清ABAb含量，具有脑保护作用，其脑保护机制可能与HT能减轻血清ABAb介导的损伤性脑细胞炎性反应有关。Objective To disclose the probably protective mechanism of mild hypothermia protecting brain through investigating the contents changes of Antibrain - Antibody（ABAb） in serum in patients with severe traunatic brain injury（sTBI） and the influence of mild hypothermia on serum levels of ABAb. Methods A total of 80 cases with sTBI were treated with noothermia-treated （NT） （NT group, n =40）and mild hypothermia（HT） （HT group, n =40） respectively. ELISA was used to measure serum levels of ABAb. Groups at 1,3,5,7 and 14 days after injury to observe the contents changes of ABAb in serum and the influence of mild hypothermia. Simultaneous analysis two groups at each time point of serum ABAb concentration and Glasgow outcome scale （GOS） of relevance was performed. Contrast analysis of clinical prognosis for patients in the two groups was carried out to reveal the protective mechanism of mild hypothermia protecting on patients with sTBI. 20 serum specimens of normal persons were used as control group. Results （ 1 ） All sTBI patients at each time point after injury, serum ABAb levels were higher than the normal control group （ P 〈0. 01 ）. （2） Concentration of antibodies in the serum ABAb levels in HT group at each time point was lower than in NT group（ P 〈0. 01）. （3） Concentration of serum ABAb levels in NT group at each time point of injury was negatively correlated with the GOS score; prognosis at discharge in HT group was better than in NT group. Condusions HT can reduce the serum ABAb levels in sTBI patients, improve the prognosis, have brain protective effect. The brain protective mechanisms may be related to the mild laypothermia which reduce the serum ABAb -mediated inflammatory damage on brain cells.

关 键 词：重型颅脑创伤 亚低温 抗脑抗体 

分 类 号：R651.15[医药卫生—外科学]