亚低温治疗对重型颅脑损伤患者血浆内皮素的影响

目的探讨亚低温治疗重型颅脑损伤的临床疗效及其对血浆内皮素(ET)分泌的调控作用。 方法选取50例重型颅脑损伤患者，分为观察组(n=25)和对照组(n=25)。对照组给予常规治疗，观察组给予常规治疗联合亚低温治疗。比较两组血浆ET表达、颅内压(ICP)及临床预后。 结果治疗后第1~5天，观察组患者血浆ET均显著低于对照组，组间比较差异显著(P<0.05)。治疗后第1~5天，观察组患者ICP均显著低于对照组，组间比较差异显著(P<0.05)。观察组中预后良好7例、轻残8例、重残6例、植物生存2例、死亡2例；对照组预后良好3例、轻残4例、重残10例、植物生存3例、死亡5例，观察组预后情况明显优于对照组，组间比较差异显著(P<0.05)。 结论亚低温治疗的脑保护作用可能与抑制ET分泌，降低ICP有关。

The efficacy of mild hypothermia on endothelin in patients with severe brain injury

ObjectiveTo evaluate the efficacy of mild hypothermia treatment on severe brain injury, and the regulating effect of plasma endothelin(ET). MethodsFifty patients with severe brain injury were divided into observation group(n=25) and control group(n=25). The control group was given to conventional therapy, and the observation group were given to conventional therapy combined with mild hypothermia. The plasma ET level, intracranial pressure(ICP) and clinical prognosis were compared between the two groups. ResultsAfter 1~5 days of treatment, the plasma ET level of observation group significantly lower than control group, the difference showed statistically significant(P<0.05). After 1~5 days of treatment, the ICP of observation group significantly lower than that of control group, the difference showed statistically significant(P<0.05). In observation group, favourable prognosis for 7 cases, mild disability for 8 cases, severe disability for 6 case, vegetable survival for 2 case and death 2 case. In control group, favourable prognosis for 3 cases, mild disability for 4 cases, severe disability for 10 case, vegetable survival for 3 cases and death 5 case. The clinical prognosis of observation group significantly better than control group, the difference showed statistically significant(P<0.05). ConclusionThe brain protective effects of mild hypothermia may be related to the inhibition of ET secretion and reduce ICP.