局部亚低温治疗急性大面积脑梗死患者的疗效和血清中神经元特异性烯醇化酶浓度、超氧化物歧化酶活力及一氧化氮浓度变化分析  

Analysis of effects and serum contents of patients with acute massive cerebral infarction treated with local mild hypothermia therapy

作　　者：阮晓兰[1] 刘春英 苗瑞杰[1] 

机构地区：[1]唐山开滦总医院林西医院神经内科,河北063103

出　　处：《脑与神经疾病杂志》2018年第1期26-29,共4页Journal of Brain and Nervous Diseases

摘　　要：目的观察局部压低温治疗急性大面积脑梗死患者的疗效,并通过血清神经元特异性烯醇化酶(NSE)浓度、超氧化物歧化酶(SOD)活力及一氧化氮(NO)浓度变化分析治疗机理。方法选取2013年4月至2017年4月因急性大面积脑梗死至本院治疗的患者98例,随机分为观察组和对照组,每组49例。对照组予以吸氧、脑保护剂、脱水降颅压、抗血小板等常规药物治疗,观察组在常规治疗的基础上予以局部亚低温治疗。比较2组治疗前后NIHSS神经功能评分、Fugl-Meyer运动功能评分及Bathel指数日常生活活动能力评分。测定并比较2组血清中NSE浓度、SOD活力及NO浓度。结果治疗前2组患者NIHSS评分、Fugl-Meyer评分及Bathel指数评分差异无统计学意义(P>0.05);治疗1个月后观察组3组评分均优于对照组,差异有统计学意义(P<0.05);入院第1天2组NSE浓度和NO浓度差异均无统计学意义(P>0.05),第3、7、14天观察组NSE浓度和NO浓度均低于对照组,差异有统计学意义(P<0.05),入院第1、3天2组血清中SOD活力差异无统计学意义(P>0.05),第7、14天观察组高于对照组,差异有统计学意义(P<0.01)。结论局部压低温治疗对急性大面积脑梗死有显著的神经功能保护和促进神经功能恢复的作用,其机制可能与促进SOD生成,避免氧自由基过氧化损害和抑制NO释放,减轻NO的毒性反应有关。Objective To observe the clinical effects of local mild hypothermia therapy and its influence on the serum contents. Method 98 patients were randomly divided into the observation group （ 49 cases ） and controlgroup （ 49 eases ） .Conventional treatments were used in both groups, and local mild hypothermia therapy was only applied in observation group. The NIHSS, Fugl Meyer Assessment Method and Bathel Index were compared before and after treatment for 30 days. The serum contents of neuro-speeific enolase （ NSE ） , superoxide dismutase （ SOD ） , and nitric oxide （ NO ） were observed after treatment for 1,3,7 and 14 days. Results There were not differences on NIHSS, Bathel index and Fugl Meyer assessment between the two groups （ P〉0.05 ） before treatment. 1 month after therapy, NIHSS assessment of treatment group was lower than that of control group, while Bathel index and Fngl Meyer assessment of treatment group were higher than those of control group （ P〈0.05 ） . Serum NSE and NO level of observation group was lower than those of control group （ P〈0.05 ） on the 3rd, 7th, 14th day after treatment. Serum SOD viability level of observation group was higher than that of control group （ P〈0.01 ） on the 3rd, 7th, 14th day after treatment. Conclusion Local mild hypothermia therapy could protect the nerve function and improve the nerve function of patients with ACI. Its mechanism may be the related to increase the synthesis of SOD and the reduction of NO release.

关 键 词：大面积脑梗死 局部亚低温 超氧化物歧化酶 一氧化氮 

分 类 号：R743.32[医药卫生—神经病学与精神病学]