CAJ | 학술논문

目的探讨局部亚低温治疗对蛛网膜下腔出血患者(SAH)颅内血流动力学参数以及血浆内皮素-1(ET-1)、降钙素基因相关肽(CGRP)水平的影响.方法 60例SAH患者按随机数字表法分组分为亚低温组和对照组各30例,对照组应用药物治疗,亚低温组在药物治疗基础上加用局部亚低温治疗.分别在治疗的第1、7、10、14天经颅多普勒(TCD)检测两组患者大脑中动脉的平均血流速度(VMCA)及脉动指数(PI),同时测定血浆ET-1、CGRP水平.结果亚低温组第7、10、14天时的VMCA明显低于对照组[7 d:(95.46±22.48) cm/s vs(110.35±32.38) cm/s,t=2.07,P＜0.05；10 d:(85.57±17.47) cm/s vs (97.64±20.55) cm/s,t =2.45,P＜0.05;14 d:(57.16±14.36) cm/svs (70.56±19.42) cm/s,t=3.04,P＜0.01]；亚低温组第10、14天时的PI值明显低于对照组[10 d:0.76±0.21 vs 0.88±0.25,t=2.01,P＜0.05;14 d:0.72±0.18 vs 0.84±0.19,t=2.51,P ＜0.05]；亚低温组第10、14天时的血浆ET-1水平明显低于对照组[10 d:(71.37±16.63) pg/mlvs (81.46±21.38)pg/ml,t=2.04,P＜0.05;14 d:(55.73±15.18)pg/ml vs (68.28±20.57) pg/ml,t =2.69,P＜0.01]；亚低温组第7、10、14天时的血浆CGRP水平明显高于对照组[7 d:(26.55±6.45)pg/ml vs (23.64±4.56)pg/ml,t=2.02,P＜0.05;10 d:(24.15±7.35) pg/ml vs(20.52±6.18)pg/ml,t =2.07,P＜0.05;14 d:(30.37±6.28)pg/ml vs (26.88 ±4.39)pg/ml,t=2.49,P ＜0.05].结论亚低温治疗降低SAH患者血浆ET-1水平,升高CGRP水平,减少蛛网膜下腔出血患者脑血管痉挛(CVS)发生率,改善SAH患者预后.
목적 탐토국부아저온치료대주망막하강출혈환자(SAH)로내혈류동역학삼수이급혈장내피소-1(ET-1)、강개소기인상관태(CGRP)수평적영향.방법 60례SAH환자안수궤수자표법분조분위아저온조화대조조각30례,대조조응용약물치료,아저온조재약물치료기출상가용국부아저온치료.분별재치료적제1、7、10、14천경로다보륵(TCD)검측량조환자대뇌중동맥적평균혈류속도(VMCA)급맥동지수(PI),동시측정혈장ET-1、CGRP수평.결과 아저온조제7、10、14천시적VMCA명현저우대조조[7 d:(95.46±22.48) cm/s vs(110.35±32.38) cm/s,t=2.07,P＜0.05；10 d:(85.57±17.47) cm/s vs (97.64±20.55) cm/s,t =2.45,P＜0.05;14 d:(57.16±14.36) cm/svs (70.56±19.42) cm/s,t=3.04,P＜0.01]；아저온조제10、14천시적PI치명현저우대조조[10 d:0.76±0.21 vs 0.88±0.25,t=2.01,P＜0.05;14 d:0.72±0.18 vs 0.84±0.19,t=2.51,P ＜0.05]；아저온조제10、14천시적혈장ET-1수평명현저우대조조[10 d:(71.37±16.63) pg/mlvs (81.46±21.38)pg/ml,t=2.04,P＜0.05;14 d:(55.73±15.18)pg/ml vs (68.28±20.57) pg/ml,t =2.69,P＜0.01]；아저온조제7、10、14천시적혈장CGRP수평명현고우대조조[7 d:(26.55±6.45)pg/ml vs (23.64±4.56)pg/ml,t=2.02,P＜0.05;10 d:(24.15±7.35) pg/ml vs(20.52±6.18)pg/ml,t =2.07,P＜0.05;14 d:(30.37±6.28)pg/ml vs (26.88 ±4.39)pg/ml,t=2.49,P ＜0.05].결론 아저온치료강저SAH환자혈장ET-1수평,승고CGRP수평,감소주망막하강출혈환자뇌혈관경련(CVS)발생솔,개선SAH환자예후.
Objective To investigate the effect of local mild hypothermia on the cerebral hemodynamic parameters,plasma Endothelin-1 (ET-1s) and calcitonin gene-related peptide (CGRPs) of the subarachnoid hemorrhage patients (SAH).Methods Sixty patients were divided randomly into local mild hypothermia group and control group (n =30 patients each group).The middle cerebral artery average blood flow rates (VMCAs) and pulse index (PIs) were detected with transcranial Doppler (TCD),plasma ET-1 s and CGRPs were tested on the D1,D7,D10,and D14,respectively.Results The VMCAs in the mild hypothermia group were lower on the D7,D10,and D14 [7 d:(95.46 ±22.48)cm/s vs (110.35 ±32.38) cm/s,t =2.07,P ＜ 0.05 ; 10 d:(85.57 ± 17.47) cm/s vs (97.64 ± 20.55) cm/s,t =2.45,P＜0.05 ;14 d:(57.16 ± 14.36)cm/s vs (70.56 ± 19.42) cm/s,t =3.04,P ＜ 0.01],PIs and plasma ET-1s were lower on the D10 and D14 compared with the control group [PIs:10 d:0.76 ±0.21 vs 0.88±0.25,t =2.01,P ＜0.05;14 d:0.72±0.18 vs 0.84 ±0.19,t =2.51,P ＜0.05] [ET-1s:10 d:(71.37 ± 16.63) pg/ml vs (81.46 ±21.38)pg/ml,t =2.04,P ＜0.05 ;14 d:(55.73 ± 15.18) pg/ml vs (68.28 ± 20.57) pg/ml,t =2.69,P ＜ 0.01].Plasma CGRPs were higher compared with the control group on the D7,D10,and D14 [7 d:(26.55 ±6.45)pg/ml vs (23.64 ±4.56)pg/ml,t =2.02,P ＜0.05;10 d:(24.15 ±7.35)pg/ml vs (20.52 ±6.18) pg/ml,t =2.07,P ＜0.05;14 d:(30.37 ±6.28)pg/ml vs (26.88 ± 4.39) pg/ml,t =2.49,P ＜ 0.05].Conclusions The mild hypothermia treatment could reduce the plasma ET-1s,improve plasma CGRPs,and improve the prognosis of the patients.