亚低温治疗对急性缺血性脑卒中后感染及预后的影响  

Effects of mild hypothermia treatment on the infection and prognosis in patients following acute ischemic stroke

作　　者：伍德生[1] 郭晋[1] 齐本权 肖恒 WU Desheng;GUO Jin;QI Benquan;XIAO Heng(Department of Emergency Medicine,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院急诊内科,安徽蚌埠233004

出　　处：《皖南医学院学报》2021年第3期253-255,259,共4页Journal of Wannan Medical College

基　　金：安徽省高校优秀拔尖人才培育资助项目(gxgwfx2019030);蚌埠医学院转化医学重点专项项目(BYTM2019015)。

摘　　要：目的:探讨亚低温治疗对急性缺血性脑卒中(AIS)后感染及预后的影响。方法:将60例急性脑卒中患者根据是否进行亚低温治疗分为常规治疗组(NT组)和亚低温治疗组(MHT组)。分析两组患者亚低温治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷(GCS)评分、Bathel指数的变化。同时测定血清白细胞计数、C反应蛋白、降钙素原、肝素结合蛋白等感染指标的变化,根据NIHSS评分判定患者的临床疗效。结果:两组治疗前NIHSS评分、GCS评分、Bathel指数以及血清白细胞计数、C反应蛋白、降钙素原、肝素结合蛋白等感染指标差异均无统计学意义。与治疗前比较,两组治疗后NIHSS评分降低(P<0.01),GCS评分、Bathel指数及血清白细胞计数、降钙素原、C反应蛋白、肝素结合蛋白等感染指标升高(P<0.01)。临床总有效率MHT组86.7%(26/30),较NT组76.7%(23/30)提高(P<0.05)。结论:亚低温治疗可以改善AIS患者的神经功能,但增加了AIS后感染的发生率,以呼吸道和泌尿道感染最为常见。Objective:To observe the effect of mild hypothermia therapy on the infection and prognosis in patients following acute ischemic stroke.Methods:Sixty patients with acute stroke were divided into conventional treatment group(NT group)and mild hypothermia treatment group(MHT group)according to the actual therapy profile.The changes of NIHSS score,Glasgow coma(GCS)score and Bathel index were analyzed before and after mild hypothermia treatment in the two groups.In addition,the changes of infection indexes,including serum white blood cell count,C-reactive protein,procalcitonin,and heparin binding protein were measured as well.Finally,the clinical efficacy for patients was evaluated according to NIHSS scoring.Results:There was no significant difference in the two groups regarding the NIHSS score,GCS score,Bathel index and levels of serum white blood cell count,C-reactive protein,procalcitonin,heparin-binding protein and other infection indexes before treatment,yet the NIHSS scores were significantly reduced in the two groups compared to the scores before treatments(P<0.01),and the GCS score,Bathel index and serum white blood cell count,procalcitonin,C-reactive protein,heparin binding protein and other infection indicators were markedly increased.The total clinical effective rate was higher in MHT group than in NT group(86.7%;26/30,vs.76.7%;23/30)(P<0.05).Conclusion:Mild hypothermia treatment can improve the nerve function of of patients with acute ischemic stroke,yet increase the incidence of infection after acute ischemic stroke,with respiratory and urinary tract infections being the most.

关 键 词：亚低温治疗 急性缺血性脑卒中 卒中后感染 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]