亚低温处理对高血压脑出血患者颅内血肿清除术后血清基质金属蛋白酶9水平及脑血流动力学的影响  

Impact of Mild Hypothermia Treatment on Serum MMP-9 Level and Cerebral Hemodynamics in Postoperative Hypertensive Intracerebral Hemorrhage Patients Underwent Intracranial Hematoma Evacuation

作　　者：苑杨[1] 刘芳[2] 栾新平[1] YUAN Yang;LIU Fang;LUAN Xin-ping(Department of Neurosurgery,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China;Department of Laboratory Medicine,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China)

机构地区：[1]新疆医科大学第二附属医院神经外科,新疆乌鲁木齐市830063 [2]新疆医科大学第二附属医院检验科,新疆乌鲁木齐市830063

出　　处：《实用心脑肺血管病杂志》2018年第6期58-61,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：新疆维吾尔自治区自然科学基金项目(2015211C108)

摘　　要：目的探讨亚低温处理对高血压脑出血(HICH)患者颅内血肿清除术后血清基质金属蛋白酶9(MMP-9)水平及脑血流动力学的影响。方法选取2015年3月—2017年3月在新疆医科大学第二附属医院行颅内血肿清除术的HICH患者58例,根据治疗方法分为对照组28例和观察组30例。在对症治疗基础上,对照组患者于颅内血肿清除术中进行常温处理,观察组患者则进行亚低温处理。比较两组患者术后1、3、5、7、14 d颅内压及血清MMP-9水平,术后1、14 d脑血流动力学指标,术后6个月预后。结果术后1 d两组患者颅内压比较,差异无统计学意义(P>0.05);术后3、5、7、14 d观察组患者颅内压低于对照组(P<0.05)。术后1 d两组患者血清MMP-9水平比较,差异无统计学意义(P>0.05);术后3、5、7、14 d观察组患者血清MMP-9水平低于对照组(P<0.05)。术后1 d两组患者大脑中动脉峰值流速(Vs)、平均血流速度(Vm)比较,差异无统计学意义(P>0.05);术后14 d观察组患者大脑中动脉Vs、Vm快于对照组(P<0.05)。观察组患者术后6个月预后优于对照组(P<0.05)。结论亚低温处理可有效降低HICH患者颅内血肿清除术后颅内压、血清MMP-9水平,改善患者脑血流动力学及预后。Objective To investigate the impact of mild hypothermia treatment on serum MMP-9 level and cerebral hemodynamics in postoperative hypertensive intracerebral hemorrhage(HICH)patients underwent intracranial hematoma evacuation.Methods A total of 58 HICH patients undergoing intracranial hematoma evacuation were selected in the Second Affiliated Hospital of Xinjiang Medical University from March 2015 to March 2017,and they were divided into control group(n=28)and observation group(n=30)according to the therapeutic methods.Based on symptomatic treatment,patients in control group received normal temperature treatment during surgery,while patients in observation group received mild hypothermia treatment during surgery.Intracranial pressure and serum MMP-9 level 1 day,3 days,5 days,7 days and 14 days after surgery,indicators of cerebral hemodynamics 1 day and 14 days after surgery,prognosis 6 months after surgery were compared between the two groups.Results No statistically significant differences of intracranial pressure was found between the two groups 1 day after surgery(P>0.05),while intracranial pressure in observation group was statistically significantly lower than that in control group 3 days,5 days,7 days and 14 days after surgery,respectively(P<0.05).No statistically significant differences of serum MMP-9 level was found between the two groups 1 day after surgery(P>0.05),while serum MMP-9 in observation group was statistically significantly lower than that in control group 3 days,5 days,7 days and 14 days after surgery,respectively(P<0.05).No statistically significant differences of peak value of flow velocity(Vs)or mean flow velocity(Vm)of middle cerebral artery was found between the two groups 1 day after surgery(P>0.05),while Vs and Vm in observation group were statistically significantly faster than those in control group 14 days after surgery(P<0.05).Prognosis in observation group was statistically significantly better than that in control group 6 month after surgery(P<0.05).Conclusion Mild hypothermia tre

关 键 词：颅内出血 高血压性 低温 颅内压 基质金属蛋白酶9 脑血流动力学 

分 类 号：R743.34[医药卫生—神经病学与精神病学]