亚低温治疗对重型颅脑损伤患者血清中sFas、sFasL、NSE表达的影响  

Effect of mild hypothermia therapy on the expression of sFas,sFasL and NSE after severe traumatic brain injury

作　　者：漆建[1] 苟章洋[1] 刘洪军[1] 唐晓平[1] 唐文国[1] QI Jian;GOU Zhang-yang;LIU Hong-jun;TANG Xiao-ping;TANG Wen-guo(Department of Neursurgery,the Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院神经外科,四川南充637000

出　　处：《川北医学院学报》2020年第6期994-997,共4页Journal of North Sichuan Medical College

基　　金：四川省教育厅科研资助项目(16ZB0234)。

摘　　要：目的:探讨重型颅脑损伤后血清中sFas、sFasL、NSE的变化规律及与神经细胞损伤和凋亡的关系,进一步探讨sFas、sFasL、NSE在亚低温治疗中的临床意义。方法:将126例重型颅脑损伤患者分为亚低温治疗组和对照组,分别于伤后第1、3、5、7天抽取肘静脉血,用ELISA双抗夹心法检测血清中的sFas、sFasL、NSE含量,比较两组患者各时间段测定值的差异性以及预后。结果:亚低温治疗组和对照组的血清中sFas、sFasL、NSE含量均在伤后第3天达高峰,随后逐渐降低,而亚低温治疗组较对照组各时间段均降低明显,差异有统计学意义(P<0.05);亚低温治疗组的患者预后好于对照组,且对照组的致死率高于亚低温组,差异有统计学意义(P<0.05)。结论:重型颅脑损伤患者血清中sFas、sFasL、NSE的表达与脑损伤后的病理变化过程一致,可作为神经细胞损伤或凋亡的检测指标。亚低温治疗可明显降低表达,抑制神经细胞的损伤和凋亡,改善重型颅脑损伤患者的预后,值得临床推广应用。Objective:To investigate the changes of sFas,sFasL,and NSE in serum after severe traumatic brain injury(sTBI)and the relationship with nerve cell injury and apoptosis,and to further explore the clinical significance of sFas,sFasL,and NSE in the treatment of mild hypothermia.Methods:126 patients with sTBI were divided into a mild hypothermia treatment group and a conventional treatment group(control group).The cubital vein blood was drawn on the 1,3,5,and 7 days after the injury,and detected the content of sFas,sFasL,and NSE in the serum by ELISA double antibody sandwich method.The differences in the measured values of the two groups of patients at each time period and the comparison of prognosis were compared.Results:The serum levels of sFas,sFasL,and NSE in the mild hypothermia treatment group and the control group all reached their peak on the third day after the injury and then gradually decreased,while the mild hypothermia treatment group was significantly lower than the control group at each period,and the differences were significant(P<0.05).The prognosis of patients in the mild hypothermia treatment group was significantly better than that of the control group,and the lethality rate of the control group was significantly higher than that of the mild hypothermia group,the difference was significant(P<0.05).Conclusion:The expressions of sFas,sFasL,and NSE in the serum of patients with sTBI are consistent with the pathological changes after brain injury and can be used as detection indicators of nerve cell injury or apoptosis.Mild hypothermia treatment can significantly reduce its expression,inhibit nerve cell damage and apoptosis,and improve the prognosis of patients with sTBI.It is worthy of clinical application.

关 键 词：亚低温治疗 重型颅脑损伤 血清sFas、sFasL、NSE含量 

分 类 号：R651.15[医药卫生—外科学]