亚低温治疗重型颅脑损伤患者临床疗效分析及对患者血清GFAP、UCH-L1、NSE、CRP水平的影响

目的探讨亚低温治疗重型颅脑损伤患者临床疗效及对患者血清神经胶质纤维酸性蛋白(GFAP)、泛素羧基末端水解酶L1(UCH-L1)、神经元特异性烯醇化酶(NSE)、C反应蛋白(CRP)水平的影响。方法 106例重型颅脑损伤患者根据随机数字表法分为治疗组(n=53)和对照组(n=53)。对照组给予降低颅内压、脱水以及营养脑细胞等常规治疗,治疗组在对照组基础上结合亚低温治疗。对比分析两组入院时、治疗后1d和治疗后5d颅内压、血糖、血清GFAP、UCH-L1、NSE、CRP指标变化以及治疗6个月后预后情况。结果两组颅内压第1天、第5天较入院时明显降低(P0.05);治疗组治疗后1、5d颅内压明显低于对照组(P0.05);两组第1、第5天血糖水平显著低于入院时(P0.05);治疗组治疗后1、5d血糖水平显著低于同期对照组(P0.05);两组血清GFAP、UCH-L1水平治疗后1、5d较入院时显著降低(P0.05);治疗组血清GFAP、UCH-L1水平治疗后1、5d显著低于对照组(P0.05);两组NSE、CRP水平治疗前比较差异无统计学意义(P0.05);治疗组NSE、CRP治疗后1d和5d明显低于同期对照组(P0.05);治疗组良好率显著高于对照组(P0.05),病死率显著低于对照组(P0.05);而两组中残、重残及植物状态对比差异无统计学意义(P0.05)。结论亚低温治疗重型颅脑损伤患者临床疗效显著,降低血清GFAP、UCH-L1、NSE、CRP水平,改善患者预后,值得进一步推广应用。

Clinical efficacy of mild hypothermia treatment and its effect on serum levels of GFAP,UCH-L1,NSE,CRP levels in patients with severe brain injury

Objective To investigate the clinical effect on mild hypothermia on patients with severe traumatic brain injury and the effect on serum levels of glial fibrillary acidic protein (GFAP),ubiquitin carboxy terminal hydrolase L1 (UCH-L1),neuron specific enolase (NSE),and C reactive protein (CRP).Methods Totally 106 cases of severe traumatic brain injury were randomly divided into treatment group (n=53) and control group (n=53).The control group was given conventional treatment such as reducing intracranial pressure,dehydration and brain protection of vegetative brain cells.The treatment group received conventional treatment combined with hypothermia therapy.The intracranial pressure,blood glucose,serum GFAP,UCH-L1,NSE,CRP levels at 1d and 5d after treatment,and post-treatment prognosis at 6 months after operation were comparatively analyzed.Results The levels of intracranial pressure,blood glucose levels,serum GFAP,UCH-L1 at 1d and 5d after treatment were significantly lower compared with the levels at admission(P＜0.05) in both groups.The serum levels of intracranial pressure,blood glucose levels,serum GFAP,UCH-L1 at 1d and 5d after treatment in the treatment group were significantly lower than those in the control group (P＜0.05).There was no significant difference in NSE,CRP levels between the two groups before treatment (P＞0.05),which were significantly lower in the treatment group than the control group 1d,5d after treatment(P＜0.05).In the treatment group,the good rate was significantly higher than that of the control group (P＜0.05),while the mortality rate was significantly lower than the control group (P＜0.05);but there was no significant difference in the moderate disability rate,severe disability rate and vegetative state rate between two groups(P＞0.05).Conclusion The hypothermia therapy in treatment of severe traumatic brain injury patients can achieve satisfactory clinical effect,which can decrease serum GFAP,UCH-L1,NSE,CRP levels and improve the prognosis of patients.