|
|
Effect of hypothermia treatment on endothelin-1 in patients with severe traumatic brain injuries |
WANG Chunlai, NING Yong, SHANG Jingrui |
Department of Neurosurgery, Shandong Provincial Corps Hospital of Chinese People's Armed Police Force, Jinan 250014, China |
|
|
Abstract Objective To explore the effect of hypothermia treatment on endothelin-1 (ET-1) in patients with severe traumatic brain injuries.Methods Clinical data of 52 patients with severe traumatic brain injuries treated at the department of neurosurgery (cerebral hemorrhage) in Shandong Provincial Corps Hospital of PAP from June 2015 to June 2020 were analyzed retrospectively. The patients were divided into hypothermia treatment group (observation group) and control group with 26 patients in each group. The control group were treated with conventional treatment, and the observation group were treated with hypothermia combined with conventional methods. ET-1 changes, intracranial pressure,Glasgow Outcome Scale(GOS) and ability of daily life(ADL) were compared to assess the efficacy.Results ET-1[(124.6±10.2),(91.7±8.4), (66.2±5.5),(45.4±4.6)ng/L] in the observation group on the 3,5,7 and 14 days after treatment were significantly lower than that in the control group [(130.4±8.7),(99.6±10.6),(72. 8±9.8),(52.0±6.8)ng/L], and the difference was statistically significant(P<0.05). Intra-cranial pressure[(18.0±3.2), (15.5±4.3), (14.5±3.2), (13.0±3.5) mmHg] in the observation group on the 3, 5, 7 and 14 days after treatment was significantly lower than that in the control group[ (19.8±4.0), (18.4±4.6), (17.5±3.7), (16.2±3.7) mmHg ](P<0.05), and the difference was statistically significant(P<0.05). GOS scores of the patients in the observation group (4.12±0.99) were higher than those in the control group (3.54±1.07) after three months, and the difference was statistically significant (t=2.981, P<0.01). ADL scores of the patients in the observation group (80.19±32.91) were higher than those in the control group (63.85±36.78) after three months, and the difference was statistically significant (t=3.198, P<0.01).Conclusions Hypothermia treatment can effectively lower the serum level of ET-1 and significantly improve prognosis in the severe traumatic brain injury patients.
|
Received: 28 October 2021
|
|
|
|
|
[1] |
周定标.神经重症医学的发展与未来[J].中华神经创伤外科电子杂志, 2015, 1(4):59-60.
|
[2] |
杨细平,涂 悦,孙洪涛,等.亚低温对重型颅脑创伤合并急性创伤性凝血病影响的临床研究[J].中华神经外科杂志,2013,29(2):142-145.
|
[3] |
Arrich J, Holzer M, Havel C, et al. Hypothermia for neuroprotection in adults after cardiopulmonary resuscitation[DB]. Cochrane Database Syst Rev, 2016, 2(2): CD004128.
|
[4] |
Maegele M, Wafaisade A, Peiniger S, et al. The role of endothelin and endothelin antagonists in traumatic brain injury: a review of the literature[J]. Neurol Res, 2011, 33(2):119-126.
|
[5] |
Adelson P D, Wisniewski S R, Beca J, et al. Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool Kids): a phase 3, randomised controlled trial[J].Lancet Neurol,2013,12(6):546-553.
|
[6] |
Yang Q W, Zhuang X R, Peng F, et al. Relationship of plasma matrix metalloproteinase-9 and hematoma expansion in acute hypertensive cerebral hemorrhage [J]. Int J Neurosci,2016,126(3):213-218.
|
[7] |
Olsen T S, Weber U J, Kammersgaard L P. Therapeutic hypothermia for acute stroke [J]. Lancet Neurol, 2003, 2(7):410-416.
|
[8] |
Kim F, Nichol G, Maynard C, et al. Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial[J]. JAMA, 2014, 311(1):45-52.
|
[9] |
张 赛,李晓红.颅脑创伤诊疗新进展[J].武警医学,2014, 25(4): 325-328.
|
[10] |
Yokobori S, Gajavelli S, Mondello S, et al. Neuroprotective effect of preoperatively induced mild hypothermia as determined by biomarkers and histopathological estimation in a rat subdural hematoma decompression model[J]. J Neurosurg, 2013, 118(2): 370-380.
|
[11] |
甘伟雄,黄海常,农胜德,等.亚低温辅助大骨瓣开颅术对重型颅脑损伤患者颅内压、内皮功能及预后的影响[J].解放军预防医学杂志,2019, 37(11): 22-24.
|
[12] |
任志文,赵 冬,刘 祺,等.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.
|
[13] |
余 菲,张 琳.不同时程亚低温治疗在重型颅脑损伤患者中的疗效比较[J].临床与病理杂志, 2019, 39(2): 338-342.
|
[14] |
Sessler D I. Temperature monitoring: the consequences and prevention of mild perioperative hypothermia[J]. South Afr J Anaesth Analy, 2014, 20(1):25-31.
|
[15] |
李亚斌,尚金星,赵志煌,等.亚低温结合右美托咪定治疗重型颅脑创伤患者影响研究[J].创伤与急危重病医学,2021, 9(6): 488-490.
|
[16] |
李志刚,姬喜荣,郑太祖,等.长时程亚低温与短时程亚低温治疗重型颅脑损伤的比较研究[J].中华危重病急救医学,2019, 31(12): 1440-1444.
|
[17] |
Masuo Y, Lshikawa Y, Kozakai T, et al. Vasoactive intestinal contractor /endothelin-2 gene expression in the murine central nervous system [J]. Bilochem Biophys Res Commun,2003,300(3):661-668.
|
[18] |
董必锋,陈 玲,李 亮,等.亚低温联合尼莫地平治疗对颅脑损伤病人血浆内皮素的影响[J].中西医结合心脑血管病杂志, 2017, 15(18): 2366-2368.
|
[1] |
. [J]. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(1): 78-80. |
|
|
|
|