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机构地区:[1]青岛市经济技术开发区第一人民医院ICU,266555
出 处:《中国医师进修杂志》2013年第5期31-33,共3页Chinese Journal of Postgraduates of Medicine
摘 要:目的观察血液滤过对重型颅脑损伤患者血清抗脑抗体含量的影响。方法选择重型颅脑损伤患者36例,按随机数字表法分为对照组(19例)和血液滤过组(17例)。对照组采用常规治疗,血液滤过组在常规治疗的基础上加血液滤过治疗7d。两组患者均于治疗后第1、3、5、7和14天采用酶联免疫吸附试验法测定血清抗脑抗体含量,并进行格拉斯哥昏迷量表(GCS)评分。结果血液滤过组治疗后第3天起,血清抗脑抗体浓度显著低于对照组[第3天:(1.28±0.25)kU/L比(1.33±0.30)kU/L;第5天:(1.37±0.17)k/L比(1.42±0.22)kU/L;第7天:(1.45±0.37)kU/L比(1.52±0.35)kU/L;第14天:(1.49±0.41)kU/L比(1.67±0.39)kU/L](P〈0.05或〈0.01)。血液滤过组治疗后第7天起,GCS评分显著高于对照组[第7天:(6.95±1.24)分比(5.74±1.51)分;第14天:(9.29±1.76)分比(7.22±1.24)分](P〈0.01)。结论血液滤过能够降低重型颅脑损伤患者血清抗脑抗体含量,改善预后。Objective To observe the effect of continuous veno-venous hemofiltration (CVVH) on serum level of antibrain-antibody (ABAb) in patients with severe traumatic brain injury. Methods Thirty- six patients with severe traumatic brain injury were randomly divided into control group (19 patients) and CVVH group (17 patients). The control group accepted conventional treatment, the CVVH group accepted CVVH treatment additionally for 7 d. ELISA was used to measure serum level of ABAb at 1,3,5,7, 14 d after treatment. The change of ABAb in serum of each group was observed. The scores of Glasgow coma scale (GCS) was assessed everyday. Results The level of ABAb in CVVH group was signiiieantly lower than that in control group from the third day after treatment[ the third day: ( 1.28± 0.25 ) kU/L vs. ( 1.33 ± 0.30) kU/L; the fifth day: (1.37 ±+0.17) kU/L vs.(1.42 ±0.22) kU/L;the seventh day: (1.45 ±0.37) kU/L vs.(1.52 ± 0.35 ) kU/L; the fourteenth day: ( 1.49 ± 0.41 ) kU/L vs. ( 1.67± 0.39) kU/L, P 〈 0.05 or 〈 0.01 ]. The scores of GCS in CVVH group was significantly higher than that in control group from the seventh day after treatment [the seventh day: (6.95 ±1.24) scores vs.(5.74 ± 1.51 ) scores;the fourteenth day: (9.29 ± 1.76) scores vs. (7.22 ±1.24) scores] (P 〈 0.01 ). Conclusion CVVH can decrease the level of ABAb and improve the prognosis.
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