亚低温治疗对重型颅脑外伤患者降钙素原、白介素―6指标的影响.docVIP

亚低温治疗对重型颅脑外伤患者降钙素原、白介素―6指标的影响 　　【摘要】 目的：研究重型颅脑损伤患者血清降钙素原、白介素-6指标的变化，并探讨亚低温治疗对脑外伤患者PCT、IL-6变化的影响。方法：采用前瞻性单中心观察研究方法，采集2012年10月-2015年12月本院重症医学科（ICU）收住的确诊为重型颅脑损伤患者（GCS评分3～8分）40例并分为两组，分别采用亚低温（33～35 ℃）和常温（36～37 ℃）处理，余治疗原则保证一致性，测定患者静脉血中PCT、IL-6水平。结果：第1天常温组PCT、IL-6值分别为（0.87±0.29）ng/mL和（101.70±30.99）pg/mL，与亚低温组PCT、IL-6值（0.88±0.27）ng/mL和（101.75±26.42）pg/mL比较，差异均无统计学意义（P0.05）；第3天常温组PCT、IL-6值分别为（0.70±0.26）ng/mL和（76.45±23.30）pg/mL，亚低温组PCT和IL-6值分别为（0.55±0.22）ng/mL和（59.90±13.20）pg/mL，均较第1天明显降低，差异均有统计学意义（P0.01）；第7天常温组PCT、IL-6值分别为（0.45±0.20）ng/mL和（50.90±17.38）pg/mL，亚低温组PCT和IL-6值分别为（0.32±0.18）ng/mL和（31.95±11.47）pg/mL，均较第3天明显降低，差异均有统计学意义（P0.01）；亚低温治疗组第3、7天静脉血PCT、IL-6含量下降趋势较常温组明显（P0.01）；亚低温组预后好于常温组（P0.05）。结论：重型颅脑外伤患者早期采用亚低温治疗可能与静脉血PCT、IL-6清除相关，并与改良预后相关。 　　【关键词】 重型颅脑损伤； 亚低温治疗； 降钙素原； 白介素-6； 预后 　　【Abstract】 Objective：To study changes in serum PCT，IL-6 indicators of patients with severe traumatic brain injury，and to explore hypothermia therapy impact to PCT，IL-6 changes in brain injuries of patients.Method：A single-center prospective observational study was used.Patients from October 2012 to December 2015 admitted into intensive care unit（ICU） of our hospital were selected.A total of 40 severe traumatic brain injury patients （Glasgow score of 3 to 8 ） were randomly divided into two groups，mild hypothermia （33-35℃） 　　and normothermia（36-37 ℃） treatment，other treatment principles to ensure consistency.The patient serum PCT，IL-6 were measured.Result：Day 1 the normothermia group PCT， IL-6 were （0.87±0.29）pg/mL and （101.70±30.99）pg/mL，and the mild hypothermia group PCT， IL-6 were（0.88±0.27）pg/mL and （101.75±26.42）pg/mL，the differences were not statistically significant（P0.05）.Day 3 the normothermia group PCT，IL-6 values were （0.70±0.26）ng/mL and （76.45±23.30）pg/mL，the mild hypothermia group PCT and IL-6 values were （0.55±0.22）ng/mL and （59.90±13.20）pg/mL，significantly lower than day 1，the differences were statistically significant （P 　　【Key words】 Severe traumatic brain injury； Mild hy