亚低温治疗对自发性脑室出血患者下丘脑-垂体轴功能的影响

Effect of Mild Hypothermia Therapy on the Function of Hypothalamic-pituitary Axis in Patients with Spontaneous Ventricular Hemorrhage

目的：探讨亚低温治疗对自发性脑室出血患者下丘脑-垂体轴功能的影响。方法纳入65例自发性脑室出血患者,分为对照组（n=32,采取常规治疗方法）与治疗组（n=33,在常规治疗基础上再给予亚低温治疗,时程3-5d）。对两组患者出血后1、14、30d的血清胰岛素样生长因子-1（IGF-1）、促肾上腺皮质激素（ACTH）、泌乳素（PRL）、卵泡刺激素（FSH）、黄体生成素（LH）、游离甲状腺素（FT4）、甲状腺刺激素（TSH）水平进行测定,并与健康成年人的相应激素水平进行比较,并对两组患者预后转归情况进行分析。结果对照组患者中激素分泌异常发生率为40．6%,治疗组患者激素异常分泌发生率为15．2%,两者间比较差异有统计学意义（ P〈0．05）。治疗组死亡率为15．1%,预后不良率为36．4%,预后良好率为48．5%；对照组死亡率为28．1%,预后不良率为46．9%,预后良好率为25．0%,两组间差异有统计学意义（P〈0．05）。结论亚低温治疗对脑室出血患者下丘脑-垂体轴神经内分泌功能有一定的保护作用,有助于改善患者的预后。

Objective To investigate the effect of of mild hypothermia therapy on the function of hypothalamic-pituitary axis in patients with spontaneous ventricular hemorrhage. Methods 65 patients were included and divided into two groups,one was control group with 32 patients who received ordinary treatment,one was therapeutic group with 33 patients who received ordina-ry treatmen and mild hypothermia therapy continuing 3-5 days. The endocrine hormones such as insulin-like growth factor-1 （IGF-1）,adrenocorticotropic（ACTH）,prolactin（PRL）,follicle-stimulating hormone （FSH）,luteinizing hormone（LH）,free thy-roxine （FT4） and thyroid stimulating hormone（TSH） level in serum were detected 1,14,30 days after hemorrhage in both groups. The endocrine hormones level and prognosis were compared between the two groups. Results The incidence of hormone abnormal-ity was 40. 6% in the control group and the incidence of hormone abnormality was15. 2% in therapeutic group,the difference was statistically significant（P〈0. 05）. In therapeutic group,the mortality was 15. 1%,patients with a bad recovery was 36. 4%,pa-tients with a good recovery was 48. 5% . In control group,the mortality was 28. 1%,patients with a bad recovery was 46. 9%,pa-tients with a good recovery was 25. 0%, the difference was statistically significant （ P 〈0. 05 ） . Conclusion Mild hypothermia therapy maybe have some protective effect on the neuroendocrine function of hypothalamic-pituitary axis in the patients of ventricu-lar hemorrhage and maybe conduce to prognosis improvement of patient.