亚低温治疗中枢性弥漫性轴索损伤的疗效及影响因素分析

目的探讨亚低温治疗对弥漫性轴索损伤（DAI）的疗效及影响其预后的因素。方法选取2010年6月至2013年11月120例DAI患者．根据随机双盲原则分为亚低温组和常温组。各60例。并选取30例健康志愿者作为正常对照组。记录患者治疗前后格拉斯哥昏迷评分（GCS）和部分各向异性指数（FA）差值，以及治疗后mRS评分，采用多元线性回归方法分析影响DAI预后的因素。结果治疗后常温组和亚低温组GCS评分均高于治疗前（P〈0．05），但亚低温组患者GCS评分升高程度明显高于常温组（P=-0．012）。相对于健康对照组，常温组和亚低温组治疗前后在胼胝体各部FA差异均有统计学意义（P〈0．05），但亚低温组患者治疗后各区域FA值均明显高于常温组（P〈0．05）。多因素线性回归结果显示年龄、吸烟、初始GCS评分以及手术方式均为影响mRS评分的因素。结论亚低温治疗对弥漫性轴索损伤有一定疗效，并能改善其预后。

Objective To investigate the effect of hypothermia on diffuse axonal injury （ DAI ） and its influential factors. Methods One hundred and twenty patients with DAI were included in this study between June 2010 and November 2013, and randomly divided into mild hypothermia group （ n=60 ） and normothermia group （ n=60 ） .Thirty healthy volunteers were included as healthy controls.The Glasgow Coma Scale （ GCS ） scores, and difference of fractional anisotropy （ FA ） were recorded before and after treatment. Besides, modified Rankin Scale （ mRS ） scores were recorded after treatment. Multiple linear regressions were used for analysing infectors of mRS. Results The GCS scores in both mild hypothermia group and normothermia group were higher after treatment （ P〈0.05 ） . Howere, the GCS scores in mild hypothermia group were much higher than normothermia group （ P=-0.012 ） . FA difference after treatment in both mild hypothermia group and normothermia group were significantly higher than healthy controls （ P〈0.05 ） .Multiple linear regressions showed that age, smoking, initial GCS score and treatment could affect the prognosis of DAI. Conclusion Hypothermia may be an effective way for treatment of diffuse axonal injury.