亚低温治疗对急性脑梗死患者的脑保护作用研究

Protective effects of mild hypothermia on patients with acute cerebral infaction

目的 探讨亚低温治疗急性脑梗死的临床效果及对患者血清细胞间粘附分子 1(intercellularadhesionmolecule 1,ICAM 1)、肿瘤坏死因子 α(tumornecrosisfactor α ,TNF α)含量的影响。方法 随机将 2 0 0 1年9月～ 2 0 0 3年 9月间连续入院的脑梗死患者分为亚低温组和对照组各 2 4例 ,亚低温组在常规药物治疗的基础上加用亚低温治疗 ,对照组为单纯的药物治疗。治疗前及治疗后 3 0d采用欧洲卒中评分量表 (Europeanstrokescale ,ESS) ,Barthel指数 (Barthelindex ,BI)、运动功能Fugl Meyer评分 (FMA)进行评价。并在第 1天、第 3天、第 7天测定患者血清ICAM 1、TNF α含量变化。结果 与对照组相比 ,亚低温组ESS ,BI ,Fugl Meyer评分明显高于对照组 (P <0 .0 1) ;血清ICAM 1、TNF α明显降低 (P <0 .0 1)。结论 亚低温治疗可抑制脑缺血后炎症反应 ,具有脑保护作用。

Objective To explore the effects of mild hypothermia on patients with acute cerebral infarction (ACI)and the contents of serum intercellular adhesion molecule1(ICAM 1) and tumor necrosis factor α(TNF α)in these patients. Methods Forty eight hospitalized patients with ACI from September 2001 to September 2003 were randomly divided into a mild hypothermia group (group 1) and a control group (group 2). All the patients were treated with routine medication, while those in group 1 were also treated with mild hypothermia. The European stroke scale(ESS), Barthel index(BI) and Fugl Meyer scores were evaluated before and at 30 days after treatment in both groups. The serum contents of ICAM 1 and TNF α in both groups were measured at 1,3 and 7 days after infarction. Results Compared with those in group 2, the scores of ESS, BI and Fugl Meyer in group 1 were higher ( P <0.01); the serum contents of ICAM 1 and TNF αwere decreased significantly( P <0.01). Conclusion Mild brain hypothermia could inhibit the inflammatory response after cerebral ischemia and exert neuroprotective effects against acute cerebral infarction.