亚低温联合胸腺喷丁对脑出血患者预后的影响

目的观察亚低温联合胸腺喷丁对脑出血患者预后的影响。方法急性脑出血患者60例,随机分为亚低温联合胸腺喷丁治疗组(观察组)和亚低温治疗组(对照组)各30例,对照组于发病后24 h内行亚低温治疗及常规治疗,观察组在对照组治疗方法的基础上同时给予胸腺喷丁静脉滴注,2组均于入院的第1、3、7天取外周静脉血采用流式细胞术检测CD3+、CD4+、CD8+细胞及CD4+/CD8+比值,并观察2组患者院内感染情况及预后。结果入院第1天2组患者CD3+、CD4+、CD8+细胞及CD4+/CD8+比较差异无统计学意义(P>0.05);入院第3天、第7天观察组CD3+、CD4+细胞及CD4+/CD8+均高于对照组,差异有统计学意义(P<0.05),2组CD8+细胞比较差异无统计学意义(P>0.05)。对照组仅CD4+细胞在入院第7天与第1天比较升高,差异有统计学意义(P<0.05)。观察组CD3+细胞第7天较第1天升高,差异有统计学意义(P<0.05);观察组CD4+细胞在第1、3、7天比较差异均有统计学意义(P<0.05),CD4+/CD8+第3天、第7天高于第1天,差异有统计学意义(P<0.05)。观察组的颅内感染率、肺部感染率、泌尿系感染率及多部位感染率均明显低于对照组,差异有统计学意义(P<0.05)。观察组和对照组在预后等级分布上差异有统计学意义(P<0.05)。结论亚低温联合胸腺喷丁治疗脑出血可以改善T细胞亚群受损情况,降低院内感染发生率,对预后有明显影响。

Effect of mild hypothermia combined with thymopentin on prognosis of patients with brain hemorrhage

Objective To observe the effect of mild hypothermia combined with thymopentin on prognosis of patients with brain hemorrhage.Methods Sixty patients with brain hemorrhage were randomly divided into the mild hypothermia combined with thymopentin group(observation group)and hypothermic treatment group(control group),thirty patients in each group.The control group was given mild hypothermia treatment and conventional therapy within 24 hours after the onset.Based on these,the observation group was given thymopentin with intravenous drop infusion.The peripheral venous blood were collected to detect the CD3+,CD4+,CD8+ cell counts and CD4+/CD8+ ratio by flow cytometry on the 1st,3rd and 7th day after admission in the two groups.The hospital onset of infection status and prognosis of patients were observed in the two groups.Results There were no statistic difference of CD3+,CD4+,CD8+ cell counts and CD4+/CD8+ ratio on the 1st day after admission between the two groups(P>0.05).The CD3+,CD4+ cell counts and CD4+/CD8+ ratio on the 3rd and 7th day after admission in observation group were significantly higher than those in control group(P<0.05);but there were no statistic difference of CD8+ cell counts between the two groups(P>0.05).The CD3+ cell counts on the 7th day were significantly higher than on the 1st day in the two groups(P<0.05).There were statistic difference of CD4+ cell counts among the 1st,3rd and 7th day in the observation group(P<0.05).The CD4+/CD8+ ratio on the 3rd and 7th day were significantly higher than on the 1st day in the observation group(P<0.05).The intracranial infection,pulmonary infection,urinary system infection and multiposition infection rates in observation group were significantly lower than those in control group(P<0.05).There was statistic difference of grade distribution of prognosis between the two groups(P<0.05).Conclusion The mild hypothermia combined with thymopentin for treatment brain hemorrhage can improve the damage of T lymphocyte subsets and decrease hospital onset of infection rate,and it could improve the prognosis of patients.