ABSTRACT
Objective To study the protective effects of mild hypothermia on cerebral and levels of serum levels of anti -brain antibodies after severe traumatic brain injury.Methods Severe traumatic brain injury were selected as the Ⅰ group (n=60),also select healthy as the Ⅱgroup (n=30),the Ⅰgroup was divided into group A (n=30)and group B (n=30)according to a random number table.The patients of group A was given hypothermia and the patients of group B were treated with temperature treatment,the levels of anti-brain antibodies in serum of each group were determined in ELISA assay,changes in cerebral blood flow before and after treatment of group A and group B were observed in Doppler,and observed Glasgow Outcome Score (GOS )of group A and group B.Results The level of anti-brain antibodies in serum of theⅠgroup was (0.59 ±0.02)U/mL significantly higher than that ofⅡ group (0.38 ±0.01)U/mL,the difference was statistically significant(t=9.192,P=0.029);the level of anti-brain antibodies in serum after treatment of group A was (1.58 ±0.03)U/ml significantly lower than that of group B (1.82 ±0.04)U/mL,the difference was statistically significant(t=10.042,P=0.019);the average flow velocity, pulse index and GCS score after treatment of group A were (54.20 ±0.23)cm/s,(0.51 ±0.02),(10.03 ±1.03) points significantly better than those of group B[(40.03 ±0.04)cm/s,(0.72 ±0.02),(8.12 ±0.02)points],the difference was statistically significant (t=9.892,10.041,9.189,P=0.021,0.018,0.026).Conclusion The lev-els of anti-brain antibodies in serum can significantly increase after severe traumatic brain injury,Hypothermia can reduce the serum levels of anti-brain antibodies,can increase cerebral blood flow.
ABSTRACT
Objective To observe the influence of different dosage of mannitol on hemodynamics after hypertensive intracerebral hemorrhage ( HIH ). Methods Sixty cases with HIH were divided into three groups by random digits table with 20 cases each. Performing routine treatment, also 20% mannitol 250 ml was used 3-4 times/d for 14-21 d in group A,20% mannitol 125 ml was used 2-3 times/d for 3-14 d in group B,and mannitol was not used in group C. The mean blood flow velocity(Vm) and pulsatility index (PI)in bleeding side of the middle cerebral artery (M1) were measured by TCD, and monitoring patient's kidney function. Results After treatment 1 d , Vm comparative differences among three groups were no statistically significant (P ＞ 0.05 ), and after treatment 10 d and 3 weeks, the Vm in group A [(45.01 ± 5.13 ), (59.41 ±7.24) cm/s] and group B [(44.61 ± 5.04), (58.94 ±7.12) cm/s] were significantly higher than those in group C [(42.42 ±4.26), (55.06 ±7.16) cm/s] (P ＜0.05), but the differences were no statistically significant between group A and group B (P ＞0.05). With the extension of treatment time, PI recovery gradually, but compared PI,after treatment 1 d, 10 d and 3 weeks,there were no statistical differences among three groups (P ＞ 0.05 ). After treatment 3 weeks, kidney function abnormal ratio in group A [35.0%(7/20)] was significantly higher than that in group B [20.0% (4/20)] and group C [15.0% (3/20)] (P＜0.05). Conclusion Using small dosage of mannitol,not only increase HIH cerebral blood flow velocity,improve brain blood perfusion,reduce cerebral ischemic injury,but also reduce kidney damage,safety is higher.