局部亚低温对脑梗死患者的脑保护机制的临床研究

摘要

目的：通过研究局部亚低温治疗前后急性脑梗死患者血清超敏C反应蛋白（Hs-CRP）、神经元特异性烯醇化酶（NSE）、白介素-1β（IL-1β）、白介素-6（IL-6）、白介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）水平的变化，探讨局部亚低温治疗对于急性脑梗死的保护机制。方法选择急性脑梗死患者90例，随机分为亚低温治疗组45例，常规治疗组45例。分别测定治疗前及治疗后3、7、14 d时两组患者血清中Hs-CRP、NSE、IL-1β、IL-6、IL-10、TNF-α的含量。结果1、常规治疗组、亚低温治疗组治疗前Hs-CRP、NSE、IL-1β、IL-6、IL-10、TNF-α水平明显高于正常对照组（P﹤0.05）；常规治疗组与亚低温治疗组治疗前Hs-CRP、NSE、IL-1β、IL-6、IL-10、TNF-α水平差异均无统计学意义（P﹥0.05）。2、两组经治疗后，血清NSE、IL-1β、IL-6、TNF-α水平呈下降趋势；Hs-CRP、IL-10水平先上升后下降。与常规治疗组相比，亚低温治疗组患者血清Hs-CRP、NSE、IL-1β、IL-6、TNF-α水平在治疗7 d、14 d后显著降低（P﹤0.05）；亚低温治疗组患者血清IL-10水平在治疗3 d、7 d后显著高于常规治疗组（P﹤0.05）。结论亚低温治疗可显著减轻脑梗死后的炎症反应，发挥其脑保护作用。%Objective To compare the levels of serum Hs-CRP, NSE, IL-1β, IL-6, IL-10 and TNF-α in patients with acute cerebral infarction treated with local mild hypothermia therapy and conventional drugs, to observe the therapeutic effect of local mild hypothermia on acute cerebral infarction and to explore the protective mechanism of mild hypothermia on cerebral ischemia.Methods90 patients with acute cerebral infarction were randomly divided into 45 cases of mild hypothermia treatment group and 45 cases in conventional treatment group. The contents of Hs-CRP, IL-1β, IL-6, TNF-α, IL-10 and NSE were measured in two groups of patients before treatment and after treatment 3, 7, 14 days respectively.Results 1.The clinical effect of two groups of patients treated with mild hypothermia for 14 days was signiifcantly better than that of the conventional treatment group (P﹤0.05). 2.Before treatment, the levels of serum Hs-CRP, NSE, IL-1β, IL-6, IL-10 and TNF-α in acute cerebral infarction patients were significantly higher than those in normal group (P﹤0.05). Before treatment, there was no signiifcant difference in the level of serum Hs-CRP, NSE, IL-1β, IL-6, IL-10 and TNF-α in the conventional treatment group and mild hypothermia group (P﹥0.05). 3.After treatment, the levels of NSE, IL-1β, TNF-αand IL-6 decreased in the two groups; Levels of IL-10 and Hs-CRP rose after a fall. Compared with the conventional treatment group, the serum levels of Hs-CRP, NSE, IL-1β, IL-6 and TNF-αsigniifcantly decreased in the treatment group after 7 days and 14 days (P﹤0.05); The serum level of IL-10 in the treatment group was signiifcantly higher than that in the conventional treatment group after 3 days and 7 days (P﹤0.05). Conclusion Local mild hypothermia therapy can significantly reduce the inflammatory response after cerebral infarction, play a protective role in the brain.