局部亚低温治疗对急性脑梗死患者疗效及可能作用机制的研究  

Clinical effect and possible mechanism of lacol mild hypothermia on acute cerebral infarction

作　　者：宋德刚[1] 陈晓雪[2] 李京龙[3] 王芳[4] 

机构地区：[1]河北省秦皇岛市第一医院神经内科,河北秦皇岛066000 [2]河北省秦皇岛市第一医院超声诊断科,河北秦皇岛066000 [3]河北省秦皇岛市第一医院核磁共振科,河北秦皇岛066000 [4]河北省秦皇岛市第一医院检验科,河北秦皇岛066000

出　　处：《河北医科大学学报》2017年第5期510-513,565,共5页Journal of Hebei Medical University

基　　金：秦皇岛市科学技术研究与发展计划(201401A191)

摘　　要：目的观察局部亚低温对急性脑梗死患者的疗效,探讨局部亚低温作用机制。方法急性脑梗死患者100例随机分为对照组及治疗组各50例。对照组给予标准内科治疗;治疗组标准治疗同时给予局部亚低温治疗,保持脑温度在33~35℃并维持24h。入院时及入院5d行颅脑MRI检查计算脑梗死体积;亚低温治疗前及治疗后(发病72h)采血检验血清超氧化物歧化酶(superoxide dismutase,SOD)及丙二醛(malondialdehyde,MDA)浓度;发病3个月后行改良Rankin量表(modified Rankin scale,mRS)评分。结果 2组患者入院时及入院5d时新发脑梗死体积差异无统计学意义(P>0.05)。发病后72h治疗组患者体内血清SOD浓度高于对照组,MDA低于对照组,治疗组预后良好(mRS评分<3分)患者多于对照组,差异均有统计学意义(P<0.05)。结论亚低温治疗可改善急性脑梗死患者预后,其机制可能为亚低温调控机体氧化应激反应。Objective To examine the effects of local mild hypothermia therapy on patients with acute cerebral infarction and to further investigate underlying mechanism for the treatment of cerebral infarction. Methods One hundred cases of cerebral infarction patients were randomly divided into two groups with 50 patients in each group. The control group was given standard medical treatment. The treatment group was given stan6ard medical treatment plus mild hypothermia with a target temperature of 33 ℃ to 35 ℃. Hypothermia was maintained for 24 hours. MRI cerebral infarction volume was observed at the first day and the fifth days after admission. Modified Rankin scale（mRS） scores were measured at 3 months after infarction. The serum levels of superoxide dismutase（SOD） and malondialdehyde（MDA） were assessed before （on admission）and after mild hypothermia therapy（at 72 h after infarction）. Results There was no difference in infarct volume between the two groups（P〉0.05）. The concentration of SOD was higher in treatment groups than in control group （P〈0.05） at 72 h after infarction. The concentration of MDA was lower in treatment groups than in control group（P〈0.05） at 72 h after infarction. Patients jn the treatment group with good prognosis （mRS〈 3 scores） were higher than those in the control group, the difference was statistically significant （P〈0. 05）. Conclusion Mild hypothermia treatment can improve the prognosis of patients with cerebral infarction, the beneficial effects may be accomplished by reducing oxidative stress reaction.

关 键 词：脑梗死 低温 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]