亚低温治疗对急性脊髓损伤患者康复情况及血清降钙素基因相关肽、5-羟色胺的影响

摘要

Objective To analyze the effects of mild hypothermia therapy on patients with spinal cord inju-ry and the changes of CGRP and 5-HT in the serum.Methods Fifty cases of spinal cord injury,who were treated in our hospital from Aug.2013 to Dec.2015,were divided into observation group and control group.Patients in the control group were treated with routine therapy,and patients in the observation group were treated with mild hypo-thermia therapy.The temperature was controlled at 30-35℃,and the temperature restored to normal within 12-20h.The patients'motor function,sensory function and rehabilitation were evaluated before treatment and 3 months after treatment,and the serum levels of CGRP and 5-HT were detected.The LSIA and Barthel index scores were used to evaluate the quality of life and the ability of the patients.The Zung depression scale was used to assess the state of depression.Results After treatment,the motor function,sensory function and overall rehabilitation score results of the two groups were significantly increased(P<0.05),and those of the observation group were significant-ly higher than in the control group(P<0.05).After treatment,CGRP and 5-HT levels in serum in the two groups were significantly increased(P<0.05),and the CGRP and 5-HT levels in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the Barthel index,Zung score and LSIA score of the two groups were significantly improved(P<0.05),and the improvement of Barthel index,Zung score and LSIA score in the observation group was significantly better than that in the control group(P<0.05).Conclusion The mild hypothermia therapy in treating spinal cord injury can effectively improve the patients'recovery,quality of life, ability and depression,and improve the level of serum 5-HT,CGRP.%目的 分析采用亚低温疗法对脊髓损伤患者干预治疗后,患者康复情况及血清中血清降钙素基因相关肽(calcitonin gene related peptide,CGRP)、5-羟色胺(5-hydroxytryptamine,5-HT)的影响.方法 将2013年8月—2015年12月收治的50例脊柱骨折伴脊髓损伤患者分为对照组和观察组:对照组患者采用常规疗法干预,观察组患者采用亚低温疗法干预,体温控制在30~35℃,梯度回温,12~20h体温恢复正常;在治疗前及治疗后3个月对患者运动功能、感觉功能及康复情况进行评价,并检测血清中CGRP、5-HT水平;使用生活满意指数A(LSIA)及Barthel指数评分对患者生活质量及能力进行评价,使用Zung抑郁状态自评量表对抑郁状态进行评定.结果 经治疗后两组患者运动功能、感觉功能及总体康复评分均显著升高(P<0.05),且观察组患者运动功能、感觉功能及总体康复评分均显著高于对照组,差异有统计学意义(P<0.05);治疗后两组血清中CGRP、5-HT水平均显著升高,差异有统计学意义(P<0.05),且观察组血清中CGRP、5-HT水平显著高于对照组,差异有统计学意义(P<0.05);两组Barthel指数、Zung评分及LSIA评分均显著改善(P<0.05),且观察组Barthel指数、Zung评分及LSIA评分改善水平显著优于对照组,差异有统计学意义(P<0.05).结论 采用亚低温疗法对脊髓损伤患者干预后可有效提高患者康复情况及生活质量、能力和心理抑郁状态,改善血清中CGRP、5-HT水平,具有较高的临床应用价值.