亚低温治疗对重型颅脑损伤患者血清Nogo-A蛋白和髓鞘碱性蛋白的影响

目的探讨亚低温治疗对重型颅脑损伤患者血清Nogo—A蛋白和髓鞘碱性蛋白（MBP）水平的影响及疗效观察。方法68例重型颅脑损伤患者分为亚低温组和对照组各34例。两组入院后均予以保持呼吸道通畅、吸氧、控制颅内压、抗感染、静脉营养神经和预防并发症等对症治疗，如有手术指征者及时予手术治疗。亚低温组患者在此基础上伤后或术后6h予以亚低温治疗3～5d。结果治疗1周后，两组血清Nogo-A蛋白和MBP水平均有明显下降（P〈0．05或P〈0．01），且亚低温组下降幅度较对照组更明显（P〈0．05）；亚低温组GCS评分改善幅度明显优于对照组（X2=6．97，P〈0．05）。结论亚低温治疗重型颅脑损伤具有较好的疗效，能明显提高患者GCS评分，促进患者意识恢复，作用机制与其能降低血清Nogo—A蛋白和MBP水平密切相关。

The effect of hypothermia treatment on serum levels of Nogo-A protein and MBP of patients with severe traumatic brain injury

Objective To explore the effect of hypothermia treatment on plasma levels of Nogo-A protein and myelin basic protein （MBP）of patients with severe traumatic brain injury. Methods Sixty-eight patients with severe traumatic brain injury were divided into observed group and control group with 34 cases in each. All the patients got symptomatic treatment as airway patency maintaintion, oxygen uptake, control intracranial pressure,anti infection,nerve nutrition and complication preventing. Patient who had the indication for surgery would receive surgery. Patients of observed group got extra treatment as hypothermia treatment for 3-5 days. Results The plasma levels of Nogo-A protein and MBP of both the two groups were reduced significantly after one weeks＇ treatment （P 〈 0.05 or P 〈 0.01 ）, and the de- clines of observed group were greater than that of control group （P 〈 0.05）, and so was the improvement of GCS score （X2=6.97 ,P 〈 0.05）. Conclusion Treating patients with severe traumatic brain injury by hypothermia treatment have a good curative effect, and it can raise GCS score and promote the consciousness recovery with relation to reducing the levels of Nogo-A protein and MBP.