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目的探讨亚低温对高血压脑出血的疗效及对血浆内皮素 (ET)含量的影响。方法 87例高血压脑出血患者随机分为亚低温组与对照组。亚低温组入院或术后 6小时入重症监护病房行亚低温治疗 ,治疗后 2 4、72小时与 3周后采用特异性放射免疫分析法测定血浆中ET含量 ,并与常温对照组进行比较。结果 2 4小时后两组患者血浆ET含量均较正常明显增高 ,亚低温组明显低于常温对照组 (P <0 .0 1) ;治疗后 72小时两组患者血浆ET均比 2 4小时明显下降 ,但亚低温组仍明显低于对照组 (P <0 .0 1) ;治疗后 3周均恢复正常。亚低温组病死率 (2 0 .9% )明显低于常温对照组(4 0 .9% ) (P <0 .0 1)。结论亚低温治疗可以明显改善高血压脑出血患者的预后 ;血浆ET水平可作为判断亚低温治疗高血压脑出血严重程度的指标。
Objective To investigate the therapeutic effect of mild hypothermia on hypertensive intracerebral hemorrhage and its effect on plasma endothelin (ET) content. Methods 87 patients with hypertensive cerebral hemorrhage were randomly divided into mild hypothermia group and control group. Mild hypothermia group admission or postoperative 6 hours into the intensive care unit line of mild hypothermia treatment, after 2 4,72 hours and 3 weeks after treatment by specific radioimmunoassay method for the determination of plasma ET content and compared with the normal temperature control group. Results After 24 hours, the levels of plasma ET in both groups were significantly higher than those in the normal group, while those in the mild hypothermia group were significantly lower than those in the normal temperature group (P <0.01). After 72 hours of treatment, the plasma ET levels in both groups were significantly higher than those in 24 hours , But the level in the mild hypothermia group was still significantly lower than that in the control group (P <0.01). The levels returned to normal after 3 weeks of treatment. Mortality in the mild hypothermia group (20.9%) was significantly lower than that in the room temperature control group (40.9%) (P <0.01). Conclusion Mild hypothermia can significantly improve the prognosis of patients with hypertensive intracerebral hemorrhage. The level of plasma ET can be used as an index to judge the severity of hypertensive intracerebral hemorrhage in mild hypothermia.