[1]刘 军 袁辉纯 徐立新.体温控制对重型颅脑损伤血肿清除术后的疗效及血清IMA、MDA的影响[J].中国临床神经外科杂志,2016,(07):412-415.[doi:10.13798/j.issn.1009-153X.2016.07.008]
 LIU Jun,YUAN Hui-chun,XU Li-xin.Effects of body temperature on serum levels of ischemia-modified albumin and malondialdehyde after surgery for intracranial hematomas in patients with severe traumatic brain injury[J].,2016,(07):412-415.[doi:10.13798/j.issn.1009-153X.2016.07.008]
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体温控制对重型颅脑损伤血肿清除术后的疗效及血清IMA、MDA的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年07期
页码:
412-415
栏目:
论著
出版日期:
2016-07-15

文章信息/Info

Title:
Effects of body temperature on serum levels of ischemia-modified albumin and malondialdehyde after surgery for intracranial hematomas in patients with severe traumatic brain injury
文章编号:
1009-153X(2016)07-0412-04
作者:
刘 军 袁辉纯 徐立新
212000 江苏镇江,江苏大学附属医院神经外科(刘 军);415003 湖南,常德市第一人民院神经外科(徐立新、袁辉纯)
通讯作者:徐立新,E-mail:xlxmd2060@hotmail.com
Author(s):
LIU Jun1 YUAN Hui-chun2 XU Li-xin2
1.Department of Neurosurgery, Affiliated Hospital, Jiangsu University, Zhenjiang 212000, China; 2.Department of Neurosurgery, The First People’s Hospital of Changde City, Changde 415003, China
关键词:
重型颅脑损伤血肿清除术缺血修饰蛋白丙二醛缺血-再灌注损伤体温控制
Keywords:
Severe traumatic brain injury Serum levels Ischemia-modified albumin Malondialdehyde Temperature control
分类号:
R 743.9; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.07.008
文献标志码:
A
摘要:
目的 探讨体温控制对重型颅脑损伤(sTBI)血肿清除术后的疗效及血清缺血修饰蛋白(IMA)、丙二醛(MDA)的影响。方法 2012年3月到2013年1月收治符合标准的sTBI 45例,均行开颅血肿清除术;术后根据体温控制水平分为观察组(25例)和对照组(20例)。观察组使用亚低温治疗仪联合冬眠药物将肛温控制在36.0~36.4 ℃,维持7 d后自然复温;对照组采用传统降温措施将肛温控制在36.5~37.7 ℃。采用ELISA法检测血清IMA、MDA水平。结果 观察组颅内压在治疗后3 d开始逐渐下降,7 d明显低于对照组(PP<0.05)。两组并发症发生率无统计学差异(>P>0.05)。两组血清IMA及MDA水平均在治疗前最高,治疗后1~7 d逐渐下降,治疗组较对照组下降更明显(P<0.05)。>结论 肛温控制在36.0~36.4 ℃对sTBI颅内血肿清除术后患者有脑保护作用,其机制可能与降低血清IMA 及MDA水平,减轻缺血再灌注损伤有关。
Abstract:
Objective To investigate the effect of body temperature on the serum levels of ischemia-modified albumin (IMA) and malondialdehyde (MDA) after the surgery for the intracranial hematomas in patients with severe traumatic brain injury (sTBI). Methods Forty-five patients with sTBI after the surgery for intracranial hematomas were divided into observed group (n=25) and control group (n=20). In observed group, mild hypothermia therapy apparatus and hibernation drugs were used to control rectal temperature at 36.0~36.4 ℃ for 7 days. In control group, conventional cooling Methods were used to control rectal temperature at 36.5~37.7 ℃. The serum levels of IMA and MDA were detected by ELISA. Results The intracranial pressure, which began to decline 3 days after the body temperature control, was significantly lower in observed group than control group 7 days after the body temperature control (P<0.05). the="" prognosis="" was="" significantly="" better="" in="" observed="" group="" than="" control="" 3="" months="" after="" body="" temperature="" (P<0.05). there="" was="" no="" significant="" difference="" in="" the="" complications="" between="" two="" groups.="" serum="" levels="" of="" ima="" and="" mda="" were="" significantly="" lower="" observed="" group="" than="" control="" 1,="" 3,="" 5,="" 7="" days="" after="" body="" temperature="" (P<0.05).>Conclusions The rectal temperature which was controlled at the range from 36.0 to 36.4 has neuroprotection in the patients with sTBI after the removal of the intracranial hematomas probably due to the decrease in the serum levels of IMA and MDA.

参考文献/References:

[1] Lu J, Gary KW, Neimeier JP, et al. Randomized controlled trials in adult traumatic brain injury [J]. Brain Inj, 2012, 26 (13-14): 1523-1548.
[2] Clifton GL, Valadka A, Zygun D, et al. Very early hypother- mia induction in patients with severe brain injury (the Na- tional Acute Brain Injury Study: Hypothermia II): a rando- mised trial [J]. Lancet Neurol, 2011, 10(2): 131-139.
[3] Clifton GL, Coffey CS, Fourwinds S, et al. Early induction of hypothermia for evacuated intracranial hematomas: a post hoc analysis of two clinical trials [J]. J Neurosurg, 2012, 117 (4): 714-720.
[4] Suehiro E, Koizumi H, Kunitsugu I, et al. Survey of brain temperature management in patients with traumatic brain injury in the Japan neurotrauma data bank [J]. J Neuro- trauma, 2014, 31(4): 315-320.
[5] Yokobori S, Frantzen J, Bullock R, et al. The use of hypo- thermia therapy in traumatic ischemic/reperfusional brain injury: review of the literatures [J]. Ther Hypothermia Temp Manag, 2011, 1(4): 185-192.
[6] 宋明浩,李志祥,马文斌. 导致脑外伤后再灌注损伤的临 床因素分析[J]. 临床和实验医学杂志,2012,11(4):254- 255.
[7] 沈鹃琴. 缺血修饰白蛋白的研究进展[J]. 浙江临床医学, 2011,13(1):89-91.
[8] Ghanizadeh A, Akhondzadeh S, Hormozi M, et al. Gluta- thione-related factors and oxidative stress in autism, a review [J]. Curr Med Chem, 2012, 19 (23): 4000-4005.
[9] Yokobori S, Gajavelli S, Mondello S, et al. Neuroprotective effect of preoperatively induced mild hypothermia as deter- mined by biomarkers and histopathological estimation in a rat subdural hematoma decompression model [J]. J Neuro- surg, 2013, 118(2): 370-380.
[10] He Y, Fujii M, Inoue T, et al. Neuroprotective effects of focal brain cooling on photochemically-induced cerebral infarc- tion in rats: analysis from a neurophysiological perspective [J]. Brain Res, 2013, 1497: 53-60.
[11] Jia F, Mao Q, Liang YM, et al. The effect of hypothermia on the expression of TIMP-3 after traumatic brain injury in rats [J]. J Neurotrauma, 2014, 31(4): 387-394.
[12] 曹健锋,晋 鑫,史载祥,等. 亚低温治疗创伤性脑损伤的 研究进展[J]. 中华神经医学杂志,2015,14(4):444-448.
[13] 任志文,赵 冬,刘 祺,等. 亚低温对重型颅脑损伤患者 血清MMP-9、颅内压和脑血流动力学的影响[J]. 中国临 床神经外科杂志,2015,20(7):398-400.

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备注/Memo

备注/Memo:
基金项目:湖南省卫生厅科研基金(B2013-147)
更新日期/Last Update: 1900-01-01