亚低温治疗对重型颅脑损伤患者免疫功能的影响

Effect of mild hypothermia on immunologic function in the patients with severe brain injury

目的研究33℃～35℃亚低温治疗对重型颅脑损伤患者免疫功能的影响。方法将41例入选的重型颅脑损伤患者（GCS评分≤8分）随机分为亚低温治疗组和常温治疗组。亚低温组20例，伤后24h内采用亚低温治疗，使直肠温度控制在33℃～35℃，维持5d；常温治疗组21例，采用传统的物理及化学方法使直肠温度控制在36．5℃～38．0℃，其他治疗两组完全相同。分别在入院后第1、3、5、7天检测两组患者血清免疫球蛋白水平和淋巴细胞转化率的动态变化。结果亚低温治疗组与常温治疗组两组患者的免疫球蛋白水平和淋巴细胞转化率在第1天、第3天、第5天和第7天均差异无统计学意义（P〉0．05）。结论5d时间内33℃～35℃的亚低温治疗不会明显抑制重型颅脑损伤患者的免疫功能。

Objective To study the effect of mild hypothermia therapy（33℃ -35℃ for 5 days） on immunologic function in the patients with severe traumatic brain injury. Methods 41 patients were randomly divided into mild hypothermia therapy （HT） group （ n = 20） and normal temperature therapy （NT） group （n = 21 ）. In the mild hypothermia therapy group, the rectal temperature （RT） was controlled at 33℃-35℃ for 5 days and 36.5℃-38.0℃ in the NT group. The other therapies were the same. In each group, the dynamic change of immunoglobulin G, A and M （ IgG, IgA, IgM） and the serum lymphocyte transformation rate（LTR） were detected on the first, third, fifth and seventh day. Results The level of the serum LTR and IgG, IgA, and IgM were not significantly different at the first, third, fifth and seventh day in two groups （P 〉 0.05）. Conclusion The 33℃ -35℃ mild hypothermia therapy can not inhibit the immunologic function of severe brain injured patients.