亚低温联合尼莫地平治疗重型颅脑损伤的疗效及对脑血流指标、血清GFAP、UCH-L1水平的影响

摘要

Objective To investigate the effects of mild hypothermia and nimodipine on the cerebral blood flow index and the levels of serum glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) in patients with severe cranlocerebral injury.Methods Seventy-six patients with severe craniocerebral injury from January 2015 to January 2016 were randomly divided into two groups:control group (n =38) treated with nimodipine,and treatment group (n =38) treated with mild hypothermia and nimodipine for 10 days.The course of treatment,the changes of cerebral blood flow,GFAP,UCH-L1,and Glasgow Coma Scale (GCS) scores were observed before and after treatment.Results The total clinical effective rate was higher in treatment group than that in control group (84.21％ vs 60.53％,P ＜0.05).After treatment,Vmean and Qmean were higher while Wv was lower in treatment group than that in control group (P ＜0.05).The levels of serum GFAP and UCH-L1 were lower in treatment group than that in control group (P ＜0.05).GCS scores were higher in treatment group than that in control group (P ＜0.05).Conclusion Mild hypothermia and nimodipine has obvious clinical curative effect,and can improve the cerebral blood flow and reduce the levels of serum GFAP,and UCH-L1 in patients with severe craniocerebral injury.%目的 探讨亚低温联合尼莫地平治疗重型颅脑损伤病人的临床疗效及对病人脑血流指标、血清胶质纤维酸性蛋白(GFAP)、泛素羧基末端水解酶1(UCH-L1)水平的影响.方法 选择我院2015年1月-2016年1月收治的重型颅脑损伤病人76例,按照随机数字表法分为观察组与对照组,各38例.对照组病人给予尼莫地平治疗,观察组在对照组基础上结合亚低温治疗.两组疗程均为10d.比较两组治疗疗程,治疗前后脑血流、GFAP、UCH-L1及格拉斯哥昏迷评分(GCS)变化.结果 观察组治疗总有效率(84.21％)高于对照组(60.53％),且差异有统计学意义(P＜0.05);观察组病人治疗后均匀血流速度(Vmean)、均匀血流量(Qmean)高于对照组,而脑血脉搏波波速(Wv)低于对照组,差异有统计学意义(P＜0.05);观察组治疗后血清GFAP、UCH-L1水平低于对照组,且差异有统计学意义(P＜0.05);观察组治疗后GCS评分高于对照组,且差异有统计学意义(P＜0.05).结论 亚低温联合尼莫地平治疗重型颅脑损伤病人临床疗效明显,可改善病人脑血流和降低血清GFAP、UCH-L1水平.