Clinical Studies Of Mild Hypothermia Therapy On Patients With Severe Traumatic Brain Injury ICP And Serum UCH-L1、GFAP Changes

Objective:By mild hypothermia therapy in patients with severe traumatic brain injury, and dynamic monitoring of changes in serum ubiquitin carboxy-terminal hydrolase-1(UCH-L1) and glial fibrillary acidic protein (GFAP) concentrations, as well as intracranial pressure (ICP) changes.Observe and analyze the effects of hypothermia on severe brain injury ICP and serum UCH-L1, GFAP concentration changes, so as to explore the possible mechanism of hypothermia treatment of severe traumatic brain injury.Methods:.Collected from March2012to December2013after injury in60patients within24h after injury revenue in our department with acute severe brain were randomly divided into mild hypothermia group and the normothermia group,30cases in each.After admission all patients implanted intracranial pressure probe, continuous dynamic monitoring of intracranial pressure and every two hours recording the values. In patients on admission (0h), after admission24h,48h,72h5d time extracting peripheral blood4ml.Meanwhile, UCH-L1, GFAP concentrations in serum were measured using a quantitative enzyme-linked immunosorbent assay (ELISA). All patients six months after the Glasgow Outcome Scale assessment based on patient prognosis. All data were analyzed using statistical software SPSS19.0.Results:Before hypothermia treatment, both groups of patients serum UCH-L1and GFAP concentrations were no significant difference (p>0.05). However, each time after hypothermia treatment, in hypothermia group,serum UCH-L1and GFAP concentrations were significantly lower than the control group (p<0.01).After mild hypothermia therapy, compared with the control group, patients in hypothermia treatment the intracranial pressure decreased more significantly, which was statistically significant (p<0.01).Hypothermia group with good prognosis was53.33%, significantly better than the30%in the control group. Hypothermia group mortality was10%lower than the control group26.66%(p<0.03). Hypothermia group of upper gastrointestinal bleeding in7cases, control group of13cases (p<0.05); Hypothermia group increased blood sugar in16cases,24cases (the control group (p<0.05). Conclusion:Hypothermia therapy can reduce brain damage factor specific UCH-L1, GFAP levels, and significantly improve the prognosis of patients. Hypothermia therapy can reduce patient’s intracranial pressure.Meanwhile, complications of hypothermia can effectively prevent through active surveillance.Therefore, the cryogenic treatment can improve the prognosis of patients with severe craniocerebral injury, decrease mortality, its mechanism may be related to significantly lower specific brain damage factor, reduce the intracranial pressure.