亚低温治疗对急性重型颅脑损伤患者血清UCH-L1、GFAP水平及预后的影响

发布时间：2018-05-31 07:57

  本文选题：颅脑损伤 + 亚低温　； 参考：《山东医药》2017年18期

【摘要】：目的观察亚低温治疗对急性重型颅脑损伤患者血清泛素羧基端水解酶-1(UCH-L1)、神经胶质纤维酸性蛋白(GFAP)及其预后的影响。方法将110例急性重型颅脑损伤患者随机分为观察组和对照组各55例,两组均积极行手术治疗,并加强吸氧、抗感染及脱水等治疗,及时纠正患者水电解质紊乱及酸碱失衡,后期可采用高压氧等治疗。观察组术后进行亚低温治疗,亚低温维持时间3~7 d。分别于入院时和入院后24、48、72 h及第5天取空腹静脉血,采用酶联免疫吸附法检测血清UCH-L1、GFAP;随访6个月,采用格拉斯哥预后评分(GOS)评价其预后。结果治疗前两组血清UCH-L1、GFAP水平比较,P均0.05;两组治疗后24、48、72 h及第5天血清UCHL1、GFAP水平均下降(P均0.05),且观察组治疗后各时间点血清UCH-L1、GFAP水平明显低于对照组(P均0.05)。随访6个月,观察组预后良好率56.36%、病死率9.09%,对照组分别为29.09%、25.45%,两组比较P均0.05。结论亚低温治疗急性重型颅脑损伤可降低血清UCH-L1、GFAP水平,从而更好地改善患者预后。
[Abstract]:Objective To observe the effect of mild hypothermia on serum carboxyl terminal hydrolase -1 (UCH-L1), glial fibrillary acidic protein (GFAP) and its prognosis in patients with acute severe craniocerebral injury. Methods 110 patients with acute severe craniocerebral injury were randomly divided into the observation group and the control group (55 cases each). The two groups were actively operated on, and the oxygen inhalation and anti sensation were strengthened. Dyed and dehydration treatment, timely correction of water electrolyte disturbance and acid-base imbalance, and later treatment with hyperbaric oxygen. The observation group was treated with hypothermia after operation, the subhypothermia maintenance time 3~7 D. was taken at the time of admission and 24,48,72 h and 5 days after admission, and serum UCH-L1, GFAP were detected by enzyme linked immunosorbent assay, followed up for 6. The prognosis was evaluated by the Glasgow prognostic score (GOS). The results of serum UCH-L1, GFAP and P were 0.05 in the two groups before treatment, and in the two groups after 24,48,72 h and 5 days, the level of UCHL1 and GFAP decreased (P 0.05), and the serum UCH-L1 in the observation group was significantly lower than that of the control group (P are 0.05) at all time points after treatment. The follow-up period was 6 months, The good prognosis rate of the observation group was 56.36%, the mortality rate was 9.09%, the control group was 29.09%, 25.45%, and the two groups compared P 0.05. conclusion that the mild hypothermia treatment of acute severe craniocerebral injury could reduce the level of serum UCH-L1 and GFAP, thus better improve the prognosis of the patients.
【作者单位】： 重庆市涪陵中心医院;
【分类号】：R651.15
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本文编号：1958883