局部亚低温对急性脑梗死患者血清一氧化氮和内皮素含量的影响

Influence of local mild hypothermia therapy on the serum contents of nitric oxide and endothelin of patients with acute cerebral infarction and its clinical signification

目的观察局部亚低温治疗和常规药物治疗脑梗死后患者血清一氧化氮(NO)和内皮素(ET)的含量变化。方法随机将收治66例急性脑梗死患者分为治疗组和对照组各33例,治疗组在药物治疗脑梗死的同时加用局部亚低温治疗技术,在发病后1、3、7、14 d进行NO、ET的测定,分别在治疗前及治疗后30 d,采用《美国国立卫生院脑卒中量表》(NIHSS)进行神经功能缺损评分,运动功能采用Fugl Meyer评价法,日常生活活动能力采用Bathel指数评分。结果在治疗后第3、7、14天亚低温组NO含量较对照组显著升高(均为P<0.01),在治疗后第7天亚低温组ET含量低于对照组(P<0.05),第3、14天亚低温组ET含量显著低于对照组(P<0.01);治疗前两组NIHSS评分、Bathel指数和Fugl Meyer评分差异均无显著性意义(P>0.05)。治疗1个月后,亚低温组NIHSS评分比常规治疗组显著降低,亚低温组Bathel指数和Fugl Meyer评分均明显高于对照组,差异有非常显著性意义。结论局部亚低温治疗对血管内皮细胞功能有较好的保护作用,可改善急性脑梗死患者神经功能缺损及预后。

Objective To observe the clinical effects of local mild hypothermia therapy and its influence on the serum contents of ni tric oxide （NO） and endothelin （ET） of patients with acute cerebral infarction （ACI）. Methods 66 patients were randomly divided into the treatment （33 cases） and control groups. Drugs were used in both groups, and local mild hypothermia therapy was only applied in treat ment groups. The recovery situation of nerve function defect was scored by NIHSS, Fugl Meyer Assessment Method and Bathel Index before and after treatment for 30 d. The serum contents of NO and ET Were observed after stroke for 1, 3, 7 and 14 d Results Serum NO level of treatment group was higher than that of control group （P 〈 0. 01 ） on the 3rd, 7th, 14th day after onset. Serum ET level of treatment group was lower than that of control group （ P 〈 0. 01, P 〈 0. 05 ） on the 3rd, 7th , 14th day after onset. There were not differences on NIHSS, Bathel index and Fugl Meyer assessment between the two groups （ P 〉 0.05 ） before treatment. I month after therapy, NIHSS assessment of treatment group was lower than that of control group, while Bathe1 index and Fugl Meyer assessment of treatment group were higher than those of control group （P 〈 O. O1 ）. Conclusions Local mild hypothermia therapy could protect vascular endothelial cell and improve the nerve function of patients with ACI.