亚低温对重型颅脑创伤患者脑源性神经营养因子表达的影响

Effect of hypothermia on the expressions of BDNF in patients with severe traumatic brain injury

目的:研究亚低温对重型颅脑创伤患者脑源性神经营养因子表达的影响及其临床意义。方法:50例重型颅脑创伤患者随机分为亚低温组24例、常规治疗组(对照组)26例。亚低温组均于伤后24h内接受亚低温治疗。ELISA测定两组患者不同时间点的血清脑源性神经营养因子水平,同时监测病人颅内压(ICP)以及生命体征、血气、血电解质及动脉血氧饱和度等,并根据GOS评估法判断预后。结果:与对照组相比,亚低温组患者血清脑源性神经营养因子表达水平明显增高(P<0.01),颅内压明显降低(P<0.01),生命体征、血气、血电解质、动脉血氧饱和度差异无显著性,无严重并发症,死亡率低,预后改善明显。结论:亚低温治疗可提高重型颅脑创伤患者血清脑源性神经营养因子的表达水平,降低颅内压,具有肯定的脑保护作用。

Objective： To study the effect of hypothermia on the expressions of brain-derived neurotrophic factor （BDNF） and its clinical significance in patients with severe traumatic brain injury （sTBI）. Methods： All 50 patients were randomly assigned into two groups,24 patients with hypothermia treatment （hypothermia group）, and 26 cases with routine treatment （control group）.Hypothermia was induced within 24 hours after brain injury.The expression level of serum BDNF was measured by ELISA method. Meantime,the intracranial pressure （ICP）,vital sign, blood gas values,blood electrolytes and arterial oxygen saturation were also measured.According to Glasgow Outcome Scale （GOS）,the prognosis was evaluated. Results： Compared with control group,the expression level of BDNF significantly increased （P〈0.01） , and ICP significantly decreased （P〈0.01） respectively in hypothermia group. The vital sign,blood gas values, blood electrolytes and arterial oxygen saturation were not significantly changed. No severe complications were found.The mortality was lower and mean GOS of the patients discharge was improved in hypothermia group than that of control group. Conclusion： In the patients with sTBI, hypothermia can protect brain tissue through increasing the expression level of BDNF and decreasing ICP, and it is a safe and effective therapy.