The Effect Of Mild Hypotherm For Apoptosis In Patient With Severe Hypertensive Intracerebral Hematoma

Objective To observe the change of the soluble form of the Fas in CSF and neuron-specific enolase in serum of patient with hypertensive cerebral hemorrhage and to find mild hypothermia effects on apoptosis and necrosis of in treating severe hypertensive cerebral hemorrhage.Method A total of 18 patients with hypertensive cerebral hemorrhage were divided into 2 groups,mild hypothermia group(MHTG ,9 cases) and conventional therapeutic group(CTG, 9 cases).In MHTG ,mild hypothermia was performed in 24 hours after intracerebral hemorrhage.The treatment durations were 24 to72 hours for the patients of rectal temperature kept at 33℃~35℃.In CTG conventional drugs were administrated. We examined the levels of the soluble form of the Fas(sFas) in the cerebrospinal fluids(CSF) and leves of neuron-specific enolase(NSE) in serum.of patients with cerebral hemorrhage using an enzyme-linked immunosorbent assay(ELISA). Comparison analyse were performed by a SPSS 13 statistical package.Results The concentrations of aFas were significantly elevated and reached the highest level at about 48~72 hour after ICH, The concentrations of aFas in the MHTG group were lower than the CTG group.(P<0.05).The concentrations of NSE were higher in patients with ICH and peaked at 1st day after hemorrhage and gradually decrease, The concentrations of NSE in the MHTG group were lower than the CTG group.(P<0.05).There was no correlation between the concentrations of aFas in CSF and the CSF/serum albumin quotient.(P>0.05) the CSF/serum albumin quotient in the MHTG group were lower than the CTG group.(P<0.05).Conclusion (l)There are primary injury and secondary neuron injury after ICH, (2)The Fas/FasL system play an important role in secondary injury and sFas may prohibit neuron apoptosis in some extent.(3)Mild hypothermia has the effect of protecting from nerve cell apoptosis and necrosis and the effect of protecting blood-brain barrier.