低温高容量血液滤过对重型颅脑损伤血清抗脑抗体含量的影响  

Affect of low temperature and high volume hemofiltration on serum level of antibrain-antibody in severe traumatic brain injury

作　　者：李国辉[1] 王俊霞[1] 肖雄木[1] 

机构地区：[1]河南科技大学第一附属医院血液净化科,河南洛阳471003

出　　处：《医药论坛杂志》2014年第11期12-14,共3页Journal of Medical Forum

基　　金：河南省卫生厅医学科技攻关项目(201003082)

摘　　要：目的 观察低温高容量血液滤过对重型颅脑损伤患者血清脑钠肽含量的影响。方法 选择重型颅脑损伤患者68例格拉斯哥昏迷量表（GCS）评分8分,按随机数字表法分为对照组（A组34例）和低温高容量血液滤过组（B组34例）。对照组采用常规治疗,低温高容量血液滤过组在常规治疗的基础上加低温高容量血液滤过治疗7d。置换液为3.0-4.0L/h,血流量为180-200ml/min;两组患者均于治疗后第1、3、5和7d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 低温高容量血液滤过组治疗后第3d起,血清抗脑抗体浓度显著低于对照组〔第3d：（1.63±0.35）k U/L比（2.17±0.30）k U/L;第5d：（1.45±0.17）k U/L比（1.97±0.22）k U/L;第7d：（1.01±0.37）k U比（1.89±0.35）k U（P〈0.05或〈0.01）〕。低温高容量血液滤过组治疗后第7d起,GCS评分显著高于对照组〔第7d：（9.95±1.13）分比（4.74±1.41）分;（P〈0.01）〕。结论 低温高容量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 low temperature and high volume hemofiltration on serum level of anti- brain - antibody（ABAb） in patients with severe traumatic brain injury. Methods Sixty- eight patients with severe traumatic brain injury and glasgow coma scale （GCS） rated 8 points were randomly divided into control group （34 patients） and Low temperature and high volume hemofiltration group（ 34 patients）. Control group with conventional thera- py, continuous blood purification group on the basis of conventional therapy plus continuous blood purification therapy 7d. Replacement fluid is 30 -40L/h blood flow 180 - 300ml/min. ELISA was used to measure serum level of ABAb at 1,3,5,7d after treatment. Nechange of ABAb in serum of each group was observed. The scores of glasgow coma scale （GCS） was assessed everyday. Results The level of ABAbin low temperature and high volume hemofihration group was significantly lower than that in control group from the third day after treatment. The scores of GCS in low temperature and high volume hemofiltration group was significantly higher than that in control group from the seventh day after treatment. Conclusion Low temperature and high volume hemofiltration can decrease the level of ABAb and improve the prognosis.

关 键 词：低温高容量血液滤过 颅脑损伤 抗脑抗体 

分 类 号：R651.1[医药卫生—外科学]