目标体温管理对重型颅脑损伤脑脊液IL-6影响的研究  

Effect of targeted body temperature management on cerebrospinal fluid IL-6 in patients with severe traumatic brain injury

作　　者：罗智熹 张磊[1] LUO Zhixi;ZHANG Lei(Department of Critical Care Medicine,Liuzhou People’s Hospital,Liuzhou 545006,Guangxi,China)

机构地区：[1]柳州市人民医院重症医学科,广西柳州545006

出　　处：《中国现代医生》2025年第10期1-5,共5页China Modern Doctor

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-B20221299)。

摘　　要：目的探讨目标体温管理对重型颅脑损伤(severe traumatic brain injury,sTBI)患者脑脊液白细胞介素-6(cerebrospinal fluid interleukin-6,CSF IL-6)及预后的影响。方法选取2022年10月至2023年10月柳州市人民医院收治的sTBI患者40例,根据随机数字表法将其分为常温组和低温组,每组20例。常温组患者将核心体温控制在36.0~37.3℃,低温组患者将核心体温控制在35.0~35.9℃,7d后自然复温。观察并比较两组患者的CSF IL-6、颅内压(intracranial pressure,ICP)、格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分、急性生理学和慢性健康状况评价Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、并发症发生率及格拉斯哥预后评分(Glasgow outcome score,GOS)。结果两组患者的CSF IL-6、ICP在伤后均升高,低温组患者7d的CSF IL-6、ICP均显著低于常温组(P<0.05)。低温组患者治疗后的GCS评分显著高于常温组,APACHEⅡ评分显著低于常温组,预后良好率显著高于常温组(P<0.05)。两组患者的并发症发生率比较差异无统计学意义(P>0.05)。结论轻度低温可降低sTBI患者的CSF IL-6水平,减轻炎症反应,降低ICP,改善临床预后,且不增加并发症发生率。Objective To investigate the effects of targeted body temperature management on cerebrospinal fluid interleukin-6(CSF IL-6)and prognosis in patients with severe traumatic brain injury(sTBI).Methods A total of 40 sTBI patients admitted to Liuzhou People’s Hospital from October 2022 to October 2023 were selected and divided into normal temperature group and low temperature group according to random number table method,with 20 patients in each group.Patients in normal temperature group controlled their core body temperature at 36.0-37.3℃,while patients in low temperature group controlled their core body temperature at 35.0-35.9℃,and rewarmed naturally after 7 days.The CSF IL-6,intracranial pressure(ICP),Glasgow coma scale(GCS)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,complication rate and Glasgow outcome score(GOS)of two groups were observed and compared.Results The CSF IL-6 and ICP of both groups were increased after injury,and the CSF IL-6 and ICP of low temperature group were significantly lower than those of normal temperature group at 7 days(P<0.05).After treatment,the GCS score of patients in low temperature group was significantly higher than that in normal temperature group,APACHEⅡscore was significantly lower than that in normal temperature group,and good prognosis rate was significantly higher than that in normal temperature group(P<0.05).There was no significant difference in incidence of complications between two groups(P>0.05).Conclusion Mild hypothermia can reduce the level of CSF IL-6 in sTBI patients,reduce inflammatory response,reduce ICP,improve clinical prognosis,and do not increase the incidence of complications.

关 键 词：目标体温管理 重型颅脑损伤 脑脊液 白细胞介素-6 预后 

分 类 号：R459.7[医药卫生—急诊医学]