局部亚低温对急性重症脑出血血管活性物质及自由基的影响及临床疗效的研究

目的　研究局部亚低温治疗急性重症脑出血患者临床疗效及其对血管活性物质NO、ET、神经肽AVP及自由基的影响。方法　随机将 78例脑出血患者分为局部亚低温组 38例和常规治疗组 (对照组 ) 4 0例 ,治疗组在药物综合治疗基础上加用局部亚低温治疗 ,对照组为单纯药物综合治疗 ,动态观察两组血浆NO、ET、AVP、MDA的变化及治疗 2 1d脑水肿带的变化和治疗 30d后临床神经功能评分。结果　治疗 15d ,局部亚低温组ET、AVP较对照组明显下降 (P <0 0 1) ,NO含量较对照组明显升高 (P <0 0 5 ) ,血浆MDA与健康对照组比较明显下降 (P <0 0 5 ) ;治疗 2 1d ,局部亚低温组脑水肿体积较对照组明显减小 (P <0 0 5 ) ;治疗 30d后局部亚低温组临床神经功能评分明显低于对照组 (P <0 0 1)。结论　局部亚低温治疗能明显抑制血管活性物质ET、AVP、MDA的过高分泌 ,调节NO分泌的减少 ,减轻脑出血患者脑水肿 ,促进患者神经功能恢复 ,提高临床疗效。

Clinical observation of the effect of the local mild hypothermia auxiliary therapy on the patients with acute severe cerebral hemorrhage and its influences on ET, NO, AVP and MDA

Objective To study clinical significance of local mild hypothermia and its influence on ET,NO,AVP,MDA in the patients with acute severe cerebral hemorrhage. Methods 78 patients were divided into two groups,treatment group (38 cases) and control group (40cases).Regular treatment was used in both groups,and the local mild hypothermia therapy was just applied in treatment group.The concentration changes of ET,NO,AVP,MDA in serum before treatment and after treatment were measured;the changes of encephaledema before treatment and the 21st day after treatment were observed.The scores of clinical neurological function before treatment and the 30th day after treatment were observed.Results 15 days after treatment,the concentration of ET, AVP in serum of treatment group were significantly lower than that of control group(P<0.01),the concentration of NO were significantly higher in treatment group than in control group(P<0.05).The concentration of MDA in serum were significantly lower in treatment group than in control group (P<0.01).The volume of encephaledema in treatment group were more significantly diminished than that in the control group at the 21st day after treatment (P<0.01).The scores of clinical neurological function in treatment group were significantly lower than those in the control group at the 30th day after treatment(P<0.01).Conclusion Local mild hypothermia therapy can significantly suppress the excessive increase of ET and AVP,also ameliorate the increase of MDA,diminish the volume of encephaledema and promote the nerve function recovery of cerebral hemorrhage patients remarkably.