亚低温对重型颅脑损伤患者血清抗脑抗体和脑血流动力学的影响  

Effect of Mild Hypothermia on Anti-brain Antibody and Cerebral Haemodynamics of Patients with Severe Traumatic Brain Injury

作　　者：李浩 秦斌 

机构地区：[1]解放军第二十二医院神经外科,青海格尔木市816000 [2]解放军第二十二医院普通外科,青海格尔木市816000

出　　处：《中国康复理论与实践》2012年第11期1052-1055,共4页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨亚低温脑保护作用的机制。方法 160例重型颅脑损伤(sTBI)住院患者分为常温治疗组和亚低温治疗组各80例。两组患者均于伤后1 d、3 d、5 d、7 d和14 d采用酶联免疫吸附法测定血清抗脑抗体含量,应用经颅多普勒观察脑血流,应用颅内压监护仪监测颅内压。记录两组患者的格拉斯哥结局评分(GOS)。结果各时点,亚低温治疗组血清抗脑抗体浓度低于常温治疗组(P<0.05)。治疗5 d后各时间点,亚低温治疗组格拉斯哥昏迷评分(GCS)均高于常温治疗组(P<0.05);治疗5 d后,亚低温治疗组收缩期血流速度、平均血流速度及搏动指数与常温治疗组相比明显改善(P<0.01);治疗3 d后,亚低温治疗组平均颅内压明显低于常温治疗组(P<0.01)。出院时,亚低温治疗组GOS较常温治疗组为佳(P<0.05)。结论亚低温能够降低sTBI患者血清抗脑抗体含量,增加脑血流,降低颅内压,改善患者预后。Objective To study the protective mechanism of mild hypothermia from severe traumatic brain injury （sTBI）. Methods 160 cases with sTBI were treated under normothermia （NT group, n=80） and mild hypothermia （HT group, n=80） respectively. Their serum level of anti-brain antibody （ABAb） was measured with ELISA, cerebral haemodynamics with transcranial Doppler, and intracranial pressure （ICP） with ICP monitor 1 d, 3 d, 5 d, 7 d and 14 d after injury, while they were assessed with Glasgow coma scale （GCS） and Glasgow outcome scale （GOS）. Results The level of ABAb was lower in HT group than in NT group （P〈0.05） at every point. The scores of GCS increased （P〈0.05）, and the volume of systole, mean and pulse index improved more in HT group 5 d after injury （P〈0.01）. The ICP was lower in HT group 3 d after injury （P〈0.01）. The score of GOS was better in HT group than in NT group when discharged （P〈0.05）. Conclusion Mild hypothermia can reduce the level of serum anti-brain antibody, improve cerebral haemodynamics, decrease ICP and improve the prognosis in patients with sTB1.

关 键 词：重型颅脑损伤 亚低温 抗脑抗体 血流动力学 颅内压 

分 类 号：R651.1[医药卫生—外科学]