亚低温对急性脊髓损伤后肿瘤坏死因子-α表达及运动功能恢复的影响

摘要

目的 探讨亚低温对急性脊髓损伤(SCI)患者损伤后血清肿瘤坏死因子-α(TNF-α)表达水平及运动功能恢复的影响.方法 回顾性分析南通大学附属医院2006年2月~2011年12月收治入院的脊柱骨折伴脊髓损伤成年患者60例临床资料,随机分为两组常规治疗组30例和亚低温组30例,用放射免疫分析法测定两组脊髓损伤患者伤后12、24、72 h外周血血清TNF-α水平.并利用Tarlow评分检测两组治疗方法对运动功能恢复的影响.结果脊髓损伤后患者血清TNF-α水平呈早期水冲样动态变化,在伤后12 h快速升至高峰,然后逐渐下降,伤后72 h恢复正常;对照组治疗后6、12、24、72 h、1周、4周时血清TNF-α水平均低于治疗前(P < 0.05);亚低温组治疗后6、12、24、72 h、1周、4周时血清TNF-α水平均低于治疗前(P < 0.05).治疗后6、12、24、72 h时亚低温组脊髓损伤患者血清TNF-α水平低于对照组(P < 0.05);亚低温组运动功能评分每个时间点都明显高于对照组,且差异有统计学意义(P < 0.05).结论 亚低温对脊髓损伤后炎症细胞因子TNF-α分泌有一定的抑制作用,并具有良好的恢复运动功能作用.%Objective To investigate the mild hypothermia on acute spinal cord injury (SCI) patients serum tumor necrosis factor-a (TNF-a) expression level and motor function recovery in rats. Methods Retrospective analysis of our hospital from February 2006 to December 2011 admitted to the spine fracture with spinal cord injury in adult patients with the clinical data of 60 cases were randomly divided into two groups, the conventional treatment group (30 cases) and mild hypothermia group (30 cases), were measured by radioimmunoassay in two groups of patients with spinal cord injury after injury of 12, 24, 72 h peripheral blood serum TNF-a level. And the use of Tarlow score for the detection of the two groups of treatment on motor function recovery in rats. Results After spinal cord injury in patients with serum TNF-a levels in early dynamic changes of water sample, after injury in 12 h quickly rose to peak, and then gradually decreased, after 72 h returned to normal; the control group after treatment of 6, 12, 24, 72 h, 1 weeks, 4 weeks in serum TNF-a levels were lower in patients with before treatment (P < 0.05); mild hypothermia group after treatment with 6, 12, 24, 72 h, 1 weeks, 4 weeks when the serum TNF-a levels were lower than those before therapy (P < 0.05). After treatment, 6, 12, 24, 72 h hypothermia group of spinal cord injury patients with serum TNF-a level lower than that of control group (P < 0.05); mild hypothermia group motor scores at each time point were significantly higher than those in the control group, and the differences were significant (P < 0.05). Conclusion Hypothermia after spinal cord injury in inflammatory cytokine secretion of TNF-a have a certain effect, and has good recovery of motor function.