亚低温治疗对重型颅脑损伤患者脑脊液中胃泌素、生长抑素表达的影响

Expression of gastrin and somatostatin in cerebrospinal fluid from severely head-injured patients with mild hypothermia

目的探讨亚低温治疗对急性颅脑损伤患者脑脊液中胃泌素、生长抑素变化的影响及临床意义。方法将23例重型颅脑损伤患者随机分成两组，对照组给予常规止血、抗感染、对症支持治疗，治疗组在此基础上加用亚低温治疗，使用控温毯，维持直肠温度32～33℃，持续4～8d后复温。于入院第1、4、8天应用放射免疫法测定脑脊液胃泌素和生长抑素表达水平。结果治疗前两组脑脊液胃泌素水平显著高于正常，治疗后治疗组显著低于对照组（P〈0．05）；治疗前两组脑脊液生长抑素水平显著低于正常，治疗后治疗组显著高于对照组（P〈0．05）。结论亚低温治疗能够升高重型颅脑损伤患者脑脊液生长抑素水平，降低胃泌素水平，降低胃溃疡的发病率。

Objective To explore the expressions of gastrin and somatostatin in cerebrospinal fluid in severely traumatic brain injury patients treated with mild hypothermia. Methods 23 patients were randomly assigned to two groups：a mild hypothermia group （twelve patients ） and a normothermia group （eleven patients ）. The mild hypothermia group was subjected to mild hypothermia for 4 - 8 days, but the normothermia group received the similar therapy except mild hypothermia. Cerebrospinal fluid samples were obtained at there time points： day 1, day 4 and day 8. Gastrin and somatostatin were measured by vadioimmunoassay. Results The gastrin in the cerebrospinal fluid of severely head-injured patients was significantly higher, and in mild hypothermia group was significantly lower than that in normothermia group. The somatostatin in the cerebrospinal fluid of severely head-injured patients was significantly lower, and in mild hypothermia group was significantly higher than that in normothennia group. Conclusions Mild hypothermia could increase somawstatin and decrease gastrin, and inhibite the stomach helcosis.