目的：观察体温控制对重型颅脑损伤患者血清 S-100B 蛋白、乳酸脱氢酶（LDH）水平以及预后的影响。方法将2013年1月-2015年4月收治的66例重型颅脑损伤的患者随机分为低温组（34例）和常规组（32例）。对照组采用常规治疗，低温组加用亚低温治疗，比较两组治疗前、治疗后1 d、3 d 和7 d 血清 S-100B 蛋白、LDH 水平。3个月后比较两组格拉斯哥预后评分（GOS 评分）。结果治疗前，低温组血清 S-100B 蛋白、LDH 水平与常规组比较无明显的差异（P ＞0．05）；治疗后，血清低温组 S-100B 蛋白、LDH 水平逐渐下降，治疗后1 d、3 d、7 d 与常规组相同时间点相比，差异均有统计学意义（P ＜0．05）。治疗后3个月，低温组 GOS 评分显著高于常规组，差异有统计学意义（P ＜0.05）。患者 GCS 评分与 S-100B、LDH 水平均呈负相关（r＝－0．382，－0．547；P ＝0．002，0．001）。结论早期控制重型颅脑损伤患者的体温能够显著降低血清 S-100B 蛋白、LDH 水平，减轻细胞凋亡，改善患者的预后。%Objective To observe the expression of S-100B protein and LDH in serum of patients with severe cranio-cerebral injury treat with mild hypothermia and influence of prognosis.Methods 66 patients with severe craniocerebral injury were randomly divided into low temperature group(34 cases)and conventional group(32 cases).The convention-al group was treated with routine treatment,the low temperature group used treat with mild hypothermia.The level of serum S-100B protein and LDH before treatment and after treatment 1 days,3 days,7 days was compared between the two groups.Glasgow prognosis score (GOS score)was compared between the two groups.Results There was no sig-nificant difference of serum S-100B protein and LDH level between the two groups (P >0.05).After treatment,the se-rum S-100B protein and LDH level of the low temperature group were gradually decreased,and compared with the con-ventional group,the difference was statistically significant after treatment 1 days,3 days,7 days(P <0.05).After treat-ment 3 months,the GOS score of the low temperature group was significantly higher than that of the conventional group,the difference was statistically significant (P < 0.05).GCS score was negatively correlated with S-100B and LDH levels (r=-0.382,-0.547;P =0.002,0.001).Conclusion Use early control of body temperature in patients with severe craniocerebral injury can significantly reduce serum S-100B protein,LDH level,reduce apoptosis and im-prove the prognosis of patients.
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