亚低温辅治重型颅脑损伤及对血清和肽素、高迁移率族蛋白B1、微管相关蛋白tau的影响

Sub-hypothermia in the adjuvant therapy for severe traumatic brain injury and its effects on serum copeptin,HMGB1 and Tau

目的研究亚低温辅治重型颅脑损伤(STBI)及对血清和肽素(Copeptin)、高迁移率族蛋白B1(HMGB1)、微管相关蛋白tau(Tau)的影响。方法选择2015年7月至2020年6月成都医学院第一附属医院收治的STBI患者96例,按随机数字表法分为试验组与对照组各48例,对照组行常规治疗,试验组在此基础上加用亚低温辅治。观察两组治疗前后嗜睡情况、日常生活能力及GCS评分;治疗前及治疗7天后脑部血流动态阻力(DR)、平均血流量(Qmean)、平均血流速度(Vmean)等脑部血流指标及颅内压,血清和肽素(Copeptin)、HMGB1、Tau水平,并发症及预后情况。结果治疗后,试验组ESS、ADL、GCS评分均大于对照组(P<0.05);治疗7天后,试验组Qmean、Vmean大于对照组,DR和颅内压小于对照组,Copeptin、HMGB1、Tau水平均低于对照组(P<0.05);试验组并发症发病率低于对照组,无残或轻残率高于对照组(P<0.05)。结论亚低温辅治STBI可降低颅内压,改善脑部血流,保护脑组织,降低血清Copeptin、HMGB1、Tau水平,减少并发症,促进患者康复。

Objective To investigate the efficacy of sub-hypothermia in the adjuvant therapy for severe traumatic brain injury(STBI)and its effects on serum copeptin,high-mobility group box1(B1 hMGB1)and microtubule-associated protein tau(Tau).Methods A total of 96 STBI patients who were admitted to our hospital from July 2015 to June 2020 were involved in this study and divided into experimental or control group using the random number table method,48 in each group.The control group was given conventional treatment.The experimental group was treated with sub-hypothermia in the adjuvant therapy on basis of the control group.Sleepiness,daily living ability and GCS score were observed before and after treatment.The cerebral blood flow index such as dynamic resistance of cerebral blood flow(DR),mean blood flow(Qmean),mean blood flow velocity(Vmean)and intracranial pressure as well as serum levels of copeptin,HMGB1 and Tau were observed before and after 7daysof treatment.The complications and prognosis were also recorded.Results After treatment,ESS score,ADL score and GCS score in the experimental group were higher than those in the control group(P<0.05).After 7 days of treatment,Qmean and Vmean were higher while the DR and intracranial pressure in the experimental group were lower than those in the control group(P<0.05).On the 7 th day after treatment,serum copeptin,HMGB1 and Tau in the experimental group were lower than those in the control group(P<0.05).The incidence of complications in the experimental group was lower than those in the control group(P<0.05).The rate of no residue or light residue in the experimental group was higher than that in the control group(P<0.05).Conclusion Sub-hypothermia in the adjuvant therapy for STBI patients can reduce the intracranial pressure,improve the cerebral blood flow,protect the brain tissue,reduce the levels of serum copeptin,HMGB1 and Tau,reduce the complications and promote the patients recovery.