头部低温对高血压性脑出血高热患者血清CORT、SOD、LPO的影响

The effect of head hypothermia on the hypertensive intracerebral hemorrhage associated with hyperthermia patient's serum CORT,SOD and LPO levels

目的探讨高血压性脑出血(HIH)高热患者血清皮质醇(CORT)、脂质过氧化物(LPO)、超氧化物岐化酶(SOD)的变化,观察头部低温对其血清中CORT、LPO、SOD含量水平的影响。方法采用放射免疫法、羟胺氧化法、丙二醛法测定54例HIH应用头部低温降温(A组)与37例应用温水擦浴、冰盐水灌肠者(B组)入院第2天及高热后第2、3、4天血清CORT、LPO、SOD水平,并对两组生存者预后生活质量进行比较。结果两组入院第2天血清CORT、SOD、LPO水平无显著性差异(P>0.05),高热第2天两组血清CORT、LPO水平均较入院第2天明显升高(P<0.05,P<0.01),SOD显著降低(P<0.01);A组高热第4天血清CORT、LPO较入院第2天和高热第2天显著降低(P<0.05,P<0.01),SOD显著升高(P<0.01);B组高热第4天较高热第2天血清CORT水平显著降低(P<0.01),SOD升高不明显(P>0.05),LPO降低不显著(P>0.05),CORT、LPO较入院第2天明显升高(P<0.05,P<0.01),SOD降低(P<0.05)。两组预后神经功能缺损评分和日常生活质量评分比较有显著性差异(P<0.05)。结论头部低温可有效使HIH高热患者血清CORT、LPO含量降低,SOD含量升高,提高预后生活质量。

Objective To study the changes of serum CORT,SOD and LPO in hypertensive intracerebral hemorrhage（HIH） associated with hyperthermia patients, and observe the effect of head hypothermia on the levels of these pactors. Methods All the cases were divided into head hypothermia treatment group （group A,n=54） and warm water bath and glacial saline enema treatment group （group B,n=37）. With the methods of radioimmunoassay,hydroxylamine oxidation and malondialdehyde,the serum CORT,SOD and LPO levels in the two groups were measured on the 2nd day after hospitalization and on the 2nd day,the 3rd day and the 4th day after hyperthermia.In addition,the life quality scores of the two groups were compared.Results There was no significant difference between the group A and group B in the serum CORT,SOD and LPO on the 2nd day after hospitalization（P〉0.05）, but the serum CORT and LPO of the two groups on the 2nd day after hyperthermia were significantly higher than that of on the 2nd day after hospitalization （P〈0.05,P〈0.01）,respectively; and the serum SOD was significantly lower than the latter（P〈 0.01）.The serum CORT and LPO of group A on the 4th day after hyperthermia were significantly lower than that of on the 2nd day after hyperthermia and after hospitalization（P〈0.05,P〈0.01） respectively, and the SOD level was significantly higher than the latter（P〈0.01）. The serum CORT of group B on the 4th day after hyperthermia was significantly lower than that of on the 2nd day（P〈0.01）, and the serum CORT and LPO were significantly higher than that of on the 2nd day after hospitalization （P〈0.05,P〈0.01）, respectively, and SOD was significantly lower than the latter. There were significant difference between group A and group B in the prognosis neurological deficit scores（NDS） and activity daily living（ADL） （P〈0.05）. Conclusion Head hypothermia can effectively decrease the serum CORT, LPO levels, and increase the SOD level of HIH associated with hyperthermia patients, can also enhance the prognosis quality of life