[Effect of head hypothermia on serum inflammatory cytokines levels in patients with hypertensive intracerebral hemorrhage].

OBJECTIVE: To study changes in interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels in hypertensive intracerebral hemorrhage (HIH) and observe the potential effect of head hypothermia. METHODS: One hundred and twenty four cases of HIH were divided into head hypothermia treatment group (n=63) and control group (n=61) according to treatment with or without head hypothermia. The serum IL-6 and TNF-alpha level in the two groups were determined on the 2nd and 8th days with enzyme linked immunoadsorbent assay (ELISA) and radioimmunoassay, and compared to those of the healthy volunteers (n=40). In addition, the life quality scores of the two groups were compared. RESULTS: The serum IL-6 and TNF-alpha levels in both head hypothermia treatment group and control group were higher on the 2nd day after hospitalization compared with the healthy controls (all P<0.01), and there was no significant difference in serum IL-6 and TNF-alpha levels on the 2nd day between the head hypothermia treatment group and control group (both >0.05). Serum IL-6 and TNF-alpha levels in the head hypothermia treatment group on the 8th day after hyperthermia were significantly lower than those on the 2nd day after hospitalization (both P<0.05), while the changes of control group was not significant (both >0.05), and significant difference in serum IL-6 and TNF-alpha was found between head hypothermia treatment group and control group on day 8 (both P<0.01). The prognosis quality of life in head hypothermia treatment group was markedly higher than the control group (P<0.05). CONCLUSION: The levels of serum IL-6 and TNF-alpha were increased significantly during early stage of HIH. Head hypothermia can effectively reduce the serum IL-6 and TNF-alpha levels of early HIH patients, and improve the prognosis quality of life as well.

[Influence of beginning time of hypothermia treatment on prognosis of extensive cerebral infarction].

OBJECTIVE: To study the influence of beginning time of cranial hypothermia treatment on the prognosis of extensive cerebral infarction(ECI) so as to establish the optimum time for such treatment. METHODS: Ninety-two ECI patients were divided into three groups. In group A hypothermia treatment was begun within 6 hours after cerebral infarction in 31 patients. In another 31 cases in group B it was begun in 7-10 hours, and in 30 cases in group C it was begun in 11-14 hours after the attack. The mortality rate, the volume of cerebral infarction, neurological deficiency score(NDS) and quality of life in survivors were determined respectively in three groups. RESULTS: The volume of cerebral infarction in group A and B was obviously smaller than that of group C after hypothermia treatment(P<0.01). The mortality rate was higher in group C (26.67% in group C, 3.23% in group A and 6.45% in group B, both P<0.05) The mortality rate was highest in cases with high body temperature in group C(P<0.05). NDS was significantly lower in survivors of groups A and B compared with group C (both P<0.05), groups A and B compared with group C(P<0.05). The NDS and quality of life of the survivors with high body temperature(P<0.05 or P<0.01). CONCLUSION: Cranial hypothermia treatment should be begun with 10 hours after illness to obtain best effect.