通讯作者: 张磊, 16981335@qq.com

DOI：10.12201/bmr.202501.00079

Effect of targeted temperature management on cerebrospinal fluid IL-6 in patients with severe craniocerebral injury

• 摘要：目的 通过对重型颅脑损伤患者实施目标体温管理，探讨对脑脊液（CSF）IL-6及预后的影响。方法 将我院重症医学科收治的40例重型颅脑损伤患者按数字法随机分为两组（常温组和低温组，每组20例），常温组将核心体温控制在36～37.3℃，低温组将核心体温控制在35～35.9℃，7d后自然复温，观察两组患者入ICU时、24h、3d、7d、14d CSF IL-6、颅内压（ICP）、治疗前后GCS评分、APACHE II评分、并发症发生率及3个月后GOS评分。结果 两组患者CSF IL-6、ICP在伤后均升高，相较常温组，低温组7d CSF IL-6、ICP下降更快，治疗后GCS评分更高，APACHE II评分更低，GOS有更高的预后良好率，上述指标比较差异均有统计学意义（P<0.05），两组并发症发生率比较差异无统计学意义（P>0.05）。结论 轻度低温（核心体温35～35.9℃）可以减少重型颅脑损伤患者CSF IL-6水平，减轻炎症反应，降低ICP，不增加并发症发生率，改善临床预后。

  关键词： 目标体温管理；重型颅脑损伤；脑脊液IL-6；预后

   

  Abstract: Objective To investigate the effect of targeted temperature management on Cerebrospinal fluid interleukin 6 and prognosis in patients with severe traumatic brain injury. Methods Forty patients with severe traumatic brain injury were randomly divided into two groups (normothermia group and hypothermic group, 20 cases in each group) , In normothermia group, the core temperature was controlled at 36-37.3℃，in hypothermic group, the core temperature was controlled at 35-35.9℃ for 7 days. The CSF IL-6, ICP, GCS score, Apache II score before and after treatment, the incidence of complications and GOS score after 3 months were observed. Results Compared with the normothermia group, the CSF IL-6 and ICP in the hypothermia group decreased more rapidly on the 7th day, GCS score was higher and APACHE II score was lower after treatment, GOS had a higher good prognosis rate, there were significant differences in the above indexes (P<0.05).There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion Mild hypothermia (core temperature 35-35.9℃) can reduce the level of cerebrospinal fluid IL-6, reduce the inflammation and ICP, no increase the incidence of complications, improve the clinical prognosis in patients with severe traumatic brain injury.

  Key words: Targeted temperature management；Severe craniocerebral injury；Cerebrospinal fluid interleukin 6；Prognosis

  提交时间：2025-01-26

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• 序号	提交日期	编号	操作
  1	2024-12-25	10.12201/bmr.202501.00079V1	下载

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