重型脑损伤亚低温治疗前后体液免疫功能的变化

目的　探讨亚低温对重型脑损伤的疗效及对患者体液免疫功能的影响。方法　 5 5例经手术治疗后重型脑损伤患者随机分为亚低温组(3 5例 )及常温对照组 (2 0例 ) ,亚低温组术后入NICU病房行亚低温治疗 ,动态观察免疫球蛋白水平 ,并与常规治疗组 (对照组 )进行比较。 6个月后进行GOS预后评估。结果　亚低温组患者GCS评分、GOS预后评估均优于对照组 (P <0 0 5 ) ;两组患者在治疗后第 3天和第 6天 ,血清IgM ,IgG ,IgA和补体C3值均下降 ,但各组间比较差异无显著意义 (P >0 .0 5 )。治疗后第 2周 ,亚低温组IgM ,IgG ,C3水平明显增高 ,与对照组比较 ,差异有显著意义 (P <0 0 5 )。结论　亚低温疗法对重型脑损伤患者体液免疫功能有明显稳定和保护作用 ,并可改善其预后。

Changes on Humoral Immune Function of the Patients with Severe Cerebral Damage after Sub-hypothermic Treatment

Objective To discuss the influence of sub-hypothermia on severe cerebral damage and humoral immune function. Methods Fifty-five patients with severe cerebral damage who had accepted operation were divided into sub-hypothermic group and normal temperature control group respectively containing 35 and 20 ones. The patients of sub-hypothermic group were administered sub-hypothermic management in NICU, and their blood immunoglobulin levels were not only monitored dynamically, but compared with that of control group as well. GOS prognosis assessment was done in six months. Results GCS score and GOS prognosis assessment of sub-hypothermic group were superior to that of control group (P<0.05). Although serum IgM, IgG and C3 levels of both the two groups went down the third and the sixth day after treatment, there were no significant differences between the two groups (P>0.05). But the levels of sub-hypothermic group went up the second week after treatment, which was significantly differed from control group (P<0.05). Conclusion Sub-hypothermic treatment clearly takes part in stabilizing and protecting humoral immune function of the patients with severe cerebral damage, and improves their prognoses.