亚低温治疗重型颅脑外伤后静脉血和脑脊液中精氨酸加压素含量的变化

Changes of argiuine vaso-pression in blood and cerebral spinal fluid(CSF)in patients with severe brain injury after treated with mild hypothermia

目的探讨亚低温治疗后重型颅脑外伤患者静脉血和脑脊液中精氨酸加压素(AVP)含量的变化。方法78例重型颅脑外伤患者(GCS≤8分)随机分成两组,分别采用亚低温(33～35℃)和常温处理。测定患者第3天、第7天静脉血和脑脊液中AVP的含量。结果亚低温组治疗后第3天、第7天静脉血和脑脊液中AVP含量均比常温组有明显降低(P＜0．05)。出院时GOS评估,亚低温组死亡率明显低于常温组(P＜0．05)。结论亚低温治疗可有效抑制AVP升高,减轻脑水肿,对脑组织的结构与功能起保护作用。重型颅脑损伤早期采用亚低温治疗可降低死亡率,提高生存率。

Objective To study the changes of blood arginine vaso - pression （AVP） levels in patients with severe brain injury after treated with mild hypotherima. Methods Seventy - eight patients with severe brain injury were divided into mild hypothermla （33～35℃ ） group and normothermia group. The blood AVP levels and CSF AVP levels were determined at the third and the seventh clay after brain injury. Results The AVP levels in blood and CSF of mild hypothermia group were lower than those of the normothermia group at the third and seventh clay after brain injury （ P 〈 0.05 ） . According to GOS, prognosis of the mild hypothermia group was better than that of the normothermia group （ P 〈 0.05） . Conclusion The mild hypothermia treatment may have inhibitive effects on the production of blood AVP, CSF AVP, and brain edema. Mild hypothermia is an effective method in the treatment of acute severe brain iniury in reducing the mortality and in increasing the survival rate.