亚低温辅助治疗对高血压颅内出血患者炎性细胞因子水平、脑血肿及脑水肿的影响

Effect of adjuvant mild hypothermia therapy on inflammatory cytokines,cerebral hemato and cerebral edema in patients with hypertensive intracranial hemorrhage

目的探讨亚低温辅助治疗对高血压颅内出血(ICH)患者炎症因子水平、脑血肿及脑水肿的影响。方法将高血压ICH患者120例,随机分为亚低温组和对照组,每组60例。两组均给予ICH常规治疗,亚低温组在常规治疗基础上给予亚低温辅助治疗。采用多田公式测量两组治疗前后脑水肿及脑血肿变化情况,运用酶联免疫吸附法检测两组患者白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、IL-1β、C-反应蛋白(CRP)的水平。结果治疗后,两组的格拉斯哥昏迷评分、脑血肿体积、脑水肿体积及各血清炎症因子水平比较,差异均有统计学意义(均P<0.05),均有随时间变化趋势(均P<0.05),分组与时间均有交互作用(均P<0.05),其中亚低温组各指标随时间变化的趋势均优于对照组。亚低温组预后良好率高于对照组(P<0.05)。结论亚低温治疗可以降低高血压ICH患者血清中炎性细胞因子水平,减轻脑血肿及脑水肿,改善患者预后。

Objective To investigate the effect of adjuvant mild hypothermia therapy on the levels of inflammatory factors,cerebral hematoma and cerebral edema in patients with hypertensive intracranial hemorrhage（ ICH）. Methods A total of 120 patients with hypertensive ICH were randomly divided into mild hypothermia group and control group,with 60 cases in each group. The two groups were given conventional treatment of ICH,and the mild hypothermia group was given adjuvant mild hypothermia therapy on the basis of conventional treatment. The changes of cerebral edema and cerebral hematoma were measured with Duotian formula before and after treatment in both groups.The levels of interleukin（ IL）-6,tumor necrosis factor-α（ TNF-α）,IL-1β and C-reactive protein（ CRP） were detected by enzyme-linked immunosorbent assay in the two groups. Results After treatment,there were significant differences in the Glasgow Coma Scale score,cerebral hematoma volume,cerebral edema volume and levels of serum inflammatory factors between the two groups（ all P〈 0. 05）,the indices above showed a tendency to change with time（ all P 〈0. 05）,there were interaction effects between group and time（ all P〈 0. 05）,and the change tendency of each index in the mild hypothermia group was superior to that in the control group. The good prognosis rate of the mild hypothermia group was higher than that of the control group（ P 〈0. 05）. Conclusion Mild hypothermia therapy can reduce the levels of serum inflammatory cytokines in hypertensive patients with ICH,alleviate cerebral hematoma and cerebral edema,and improve the prognosis of the patients.