头颅局部亚低温对颅内感染患者近期疗效的观察  

Oberservation of short-term therapeutic effect of local mild hypothermia on intracranial infection

作　　者：梁成[1] 晏红[1] 施鑫鹤[1] 李建雄[1] 金晶[1] 刘伟[1] 阎湘[1] 石正洪[1] 

机构地区：[1]兰州大学第二医院神经内科,甘肃兰州730030

出　　处：《临床荟萃》2013年第10期1101-1103,共3页Clinical Focus

摘　　要：目的观察头颅局部亚低温对颅内感染患者的近期疗效并探讨其可能的机制。方法 40例颅内感染患者,其中病毒性脑炎12例,结核性脑膜炎16例,化脓性脑膜炎12例,以上患者随机分为两组,亚低温治疗组在常规药物治疗的基础上加用局部亚低温治疗,常温治疗组为单纯常规药物治疗。分别应用双抗体夹心酶联免疫吸附测定(ABC-ELISA)法和放射免疫法测定患者血清和脑脊液中基质金属蛋白酶9(MMP-9)、神经元特异性烯醇化酶(NSE)含量,进行脑脊液的常规和生化检测。结果亚低温治疗7天后,亚低温治疗组脑脊液中白细胞、蛋白、颅内压明显较常温组下降,糖升高(P<0.01);亚低温治疗组的NSE、MMP-9较常温组明显下降(P<0.01);各观察组MMP-9和NSE的含量均显著高于对照组(P<0.01)。结论颅内感染过程中存在着血脑屏障受损和神经元损伤,亚低温可以同时减少神经细胞的损伤及改善血脑屏障,从而发挥良好的治疗作用。Objective To observe the short-term therapeutic effect of local mild hypothermia on intracranial infection and mechanisms.Methods Forty patients with encephalic infections（12 viral encephalitis,16 tuberculous meningitis,12 purulent meningitis）were classified into two groups,i.e.,normal temperature subgroup and mild hypothermia subgroup.The mild hypothermia subgroup was used mild hypothermia therapy.RIA was rented for concentration of serum and CSF NSE,enzyme-linked immunosorbent assay（ELISA）was used to detect concentration of serum and CSF MMP-9.Routine and biochemical test were made on cerebral spinal fluid（CSF）.Results After local mild hypothermia therapy for seven days,WBC,protein,intracranial pressure（ICP）in mild hypothermia group were declined more sharply,but the glucose raised more compared with normal temperature group（P 0.01）;The concentration of NSE and MMP-9 of mild hypothermia group were declined more sharply than those of normal temperature group.Conclusion Blood brain barrier damage and the encephalic damage exist in the intracranial infection.Local mild hypothermia can decrease the damage of nerve cell,and benefit microcirculation.

关 键 词：脑炎 低温 基质金属蛋白酶9 神经元特异性烯醇化酶 

分 类 号：R512.3[医药卫生—内科学]