亚低温治疗通过上调IL-10表达水平降低脑出血后MODS发生率  

Mild hypothermia can decrease incidence of multiple organ dysfunction syndrome after intracerebral hemorrhage by up-regulating interleukin-10

作　　者：魏亮[1] 王琦[1] 杨成[1] 张燕飞[1] 管宏新[1] 孙志扬[1] 

机构地区：[1]同济大学附属上海市东方医院神经外科,上海200120

出　　处：《中华神经医学杂志》2016年第5期494-496,共3页Chinese Journal of Neuromedicine

基　　金：上海市卫生和计划生育委员会面上项目（201440319）;上海市浦东新区卫生和计划生育委员会面上项目（PW2014A-15）

摘　　要：目的探讨亚低温治疗对脑出血患者多器官功能障碍综合征（MODS）发生的作用及其作用机制。方法选择自2014年3月至2015年12月上海市东方医院神经外科重症监护病房住院的48例脑出血患者，依据术后体温分为亚低温治疗组（n=27）和常规治疗组（n=21），统计2组MODS的发生率，并在术后1、2、5、7、14、21 d时，使用ELISA法检测患者血清中IL-10的表达水平，使用Simple Western检测患者外周血淋巴细胞中转录因子腺病毒E4启动子结合蛋白-4（E4BP4）的表达水平。结果亚低温治疗组MODS的发生率为11.11%，而常规治疗组为28.57%，差异有统计学意义（P〈0.05）。术后1、2、5、7、14、21 d时亚低温治疗组IL-10、E4BP4表达水平均明显高于常规治疗组，差异均有统计学意义（P〈0.05）。结论亚低温治疗可以有效降低脑出血患者MODS的发生率；IL-10在亚低温治疗降低MODS发生中可能有一定的作用，机制与转录因子E4BP4上调IL-10的表达有关。Objective To examine whether mild hypothermia can decrease the incidence of multiple organ dysfunction syndrome （MODS） in patients after intracerebral hemorrhage. Methods Forty-eight patients with intracerebral hemorrhage, admitted to our hospital from March 2014 to December 2015, were divided into two groups： one was treated with mild hypothermia, and another was treated with normal methods after the surgery; the incidence of MODS was calculated between the two groups. Serum intefleukin-10 （IL-10） levels were measured with enzyme-linked immunosorbent assay and E4 promoter-binding protein 4 （E4BP4） levels were measured with Simple Western in peripheral blood lymphocytes one, two, 5, 7, 14 and 21 d after surgery. Results The incidence of MODS in patients with mild hypothermia treatment was 11.11% and that in patients with normal treatment was 28.57%, with significant difference （P〈0.05）. The IL-10 and E4BP4 levels in patients with mild hypothermia treatment were significantly higher than those in patients with normal treatment （P〈0.05）. Conclusion Mild hypothermia can decrease the incidence of MODS in patients after intracerebral hemorrhage, IL-10 has some role, and E4BP4 is associated with release ofinterleukin-10.

关 键 词：脑出血 亚低温 多器官功能障碍综合征 白介素-10 腺病毒E4启动子结 合蛋白-4 

分 类 号：R743.34[医药卫生—神经病学与精神病学]