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目的:观察亚低温对急性脑卒中合并全身炎症综合征(SIRS)患者C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的影响。方法:选择急性脑卒中并发SIRS的患者80例,采用前瞻性单盲随机对照研究。全部病例随机分为亚低温和常规治疗组,常规治疗组给予常规治疗(包括脱水、使用脑保护剂、控制血压和血糖、抗感染、营养支持等),亚低温治疗组使用低温床使患者肛温保持在33～35℃,检测入院第1、3、14d血清CRP、TNF-α、IL-6水平,进行比较。结果:入院d1两组患者血清CRP、TNF-α及IL-6水平同治疗组相比无差异(P>0.05),亚低温组d3、d14血清CRP、TNF-α及IL-6水平低于同期常规治疗组(P<0.05)。结论:亚低温能降低患者血清CRP、IL-6及TNF-α水平,减少炎症介质的释放,改善炎症反应,有助于改善脑卒中合并SIRS患者的预后。
Objective: To observe the effects of mild hypothermia on C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients with acute stroke complicated with systemic inflammatory syndrome (SIRS). Methods: Eighty patients with acute stroke complicated by SIRS were selected and prospective, single-blind randomized controlled study. All patients were randomly divided into mild hypothermia and conventional treatment group, conventional treatment group given conventional treatment (including dehydration, the use of brain protective agent, blood pressure and blood glucose control, anti-infection, nutritional support, etc.) The temperature was maintained at 33-35 ° C, and the levels of serum CRP, TNF-α and IL-6 on the 1st, 3rd, 14th day after admission were detected and compared. Results: Serum levels of CRP, TNF-α and IL-6 in the two groups were not significantly different from those in the control group (P> 0.05), but the levels of CRP, TNF-α and IL-6 in the hypothermia group were lower than those in the hypothermia group The same period conventional treatment group (P <0.05). Conclusion: Mild hypothermia can reduce serum CRP, IL-6 and TNF-α levels, reduce the release of inflammatory mediators and improve the inflammatory response, and help to improve the prognosis of stroke patients with SIRS.