摘要
目的探讨亚低温治疗对重型颅脑损伤(STBI)患者血清肿瘤坏死因子(TNF)和白细胞介素(IL)水平的影响。方法 52例STBI患者随机均分为两组:B组给予脱水、止血、抗炎及神经营养药物等常规治疗;A组加用亚低温治疗。定期进行电解质、血常规、血糖、血气分析、心肌酶谱及肝肾功能检查,严密监护体征。于治疗第1天、第7天和第14天采集肘静脉血5ml,用ELISA法检测血清TNF-α、IL-2、IL-6及IL-10水平。记录伤后6个月时的格拉斯哥预后分级(GOS)。结果治疗期间,A组血清IL-2和IL-10水平高于B组(P<0.01),而血清IL-6和TNF-α水平低于B组(P<0.01)。A组预后良好率和中残率均稍高于B组,而重残率、植物生存率和死亡率均稍低于B组(P>0.05)。结论创伤性脑损伤后,亚低温治疗可能通过抑制创伤后炎症反应和改善机体免疫状态达到脑保护作用。
Objective To explore the effects of mild hypothermia on tumor necrosis factor （TNF） and interleukin（IL） in the patients with severe traumatic brain injury（STBI）. Methods A total of 52 patients with STBI was equally randomized into two groups of B（treated with conventional therapy under normal temperature） and A （treated with additional mild hypothermia）. The electrolytes, blood glucose, blood gas analysis, myocardial enzymes and hepatorenal functions were detected regularly, while physical signs were monitored during treatment. Serum TNF-α, IL-2, IL-6 and IL-10 were detected by ELISA on the 1st , 7th and 14th day during treatment. Glasgow outcome scale（GOS） after 6 months was recorded. Results Serum levels of IL-2 and IL-10 were higher, but those of IL-6 and TNF-α were lower, in group A than those in group B（P〈0. 01）. Compared to group B, the favorable prognostic rate and moderate disability rate were higher, but the severe disability rate and plant survival rate and mortality were slightly lower in group A（P〉0. 05）. Conclusion After traumatic brain injury, additional mild hypothermia has an effective brain-protective effect by inhibiting traumatic inflammation responses and improving immunological condition.
出处
《江苏医药》
CAS
北大核心
2014年第18期2164-2166,共3页
Jiangsu Medical Journal
关键词
重型颅脑损伤
亚低温
肿瘤坏死因子Α
白细胞介素
Severe traumatic brain-injuryl Mild hypothermia
Tumor necrosis factor-α
Interleukin
