| Objective: To observe efficacy and safety of treating great area cerebral infarction by the brain-located moderate hopythermia therapy (MHT), study the mechanism and provide effective clinical treatment of great area cerebral infarction. Methods: We collected 43 great area cerebral infarction (d≥4.6cm, S≥20cm2) patients within 72 hours after stroke onset in the neurological department of the first hospital of Jilin university, and randomly assigned them to either MHT (20 cases) or control group(23 cases). There was no significant difference in clinical features between the two groups. Drugs were used in both groups, and the located MHT was only applied to the MHT group. According to the CT scan, we place the device on the cranial surface nearest to the leisure and kept the temperature (10℃) for 72 hours. All patients were observed the NIH nerve function scores before the treatment and 7, 14 and 30 days after the treatment, and the Barthel index scores 30 days after the treatment. The NSE(neuron-specific enolase), SOD (superoxide dismutase), NO and ET (endothelin) were determined 7 and 14 days after the treatment. We also observed the breath, pulp and serum potassium etc. We compared the above-mentioned indexes in MHT group with those in control group by Student t test. Results: 1. The nerve function scores of the MHT group 7 days were lower than the control group, but there was no significant difference. The nerve function scores of the MHT group 14 and 30 days were lower than the control group, and there were significant differences between them. The Barthel index of the MHT group 30 days were higher than the control group and there were significant differences (p<0.05). 2. MHT could reduce NO and NSE, but increase SOD in 7 and 14 days after the treatment and there were significant differences between the two groups. There was no significant difference of the ET between the two groups, while the ET in the MHT group was lower than the control group and there were significant differences (p<0.05). 3. No obvious difference was found in breath, pulp and serum potassium etc. before and after the treatment between the two groups (p>0.05). Discussions: Acute ischemic strokes carry the high morbidity and mortality especially great area cerebral infarction which develops fast with severe nerve function deficiencies and high mortality and the survivors have severe delayed sequelaes. Because of the unhappiness and inconvenience to the patients and the burden to the family and society they bring about, how to progress the brain-protective treatment to this kind of patients, reduce the mortality and improve the prognosis become an important question. Since the mid-eighties of 20 century, a large number of experimental studies abroad demonstrates a beneficial efficacy of MHT on the alleviation of the harms and improvement of the nerve function after the strokes. The efficacy of MHT are achieved through a lot of ways and many experiments and clinical studies adopt the method which lowers the body temperature and has many side-effects. In recent years, the efficacy of brain-located MHT were accepted by persons. Our study shows the improvements of nerve function scores in the MHT group which demonstrates the protective efficacy of MHT in the peri-infarct region of great area cerebral infarction. The higher Barthel index scores in the MHT group compared with the control group shows that MHT can improve the prognosis, the day-life ability and the living quality. The low NSE in both groups before the treatment shows there was neuron death in the early time of the infarction. The NSE in the MHT group is significantly lower than the control group in 7 and 14 days, which demonstrates the protective action of MHT. MHT can lower ET and increase SOD. The MHT may have inhibitive efficacy on the production of free radicals oxidation and the lipid peroxidation responses and therefore play a neuroprotective action. We can infer from the study that the brain-located MHT provide a protective effect... |
PDF Full Text Request