Improvement of neurological function and stress in patients with acute massive cerebral infarction by mild hypothermia: a prospective randomized controlled study
10.3760/cma.j.issn.2095-4352.2019.08.009
- VernacularTitle:亚低温治疗对急性大面积脑梗死患者神经功能及应激状况的改善作用:一项前瞻性随机对照研究
- Author:
Xinyu ZHANG
1
;
Xin ZHAO
;
Chongyang ZHANG
;
Zhe LYU
Author Information
1. 秦皇岛市第一医院急诊科 066000
- Keywords:
Acute cerebral infarction;
Mild hypothermia;
Neurological function;
Stress status;
Therapeutic effect
- From:
Chinese Critical Care Medicine
2019;31(8):958-961
- CountryChina
- Language:Chinese
-
Abstract:
To study the effect of mild hypothermiaon neurological function and oxidative stress in patients with acute massive cerebral infarction. Methods Sixty patients with acute massive cerebral infarction (within 12 hours of onset, the age < 70 years old) admitted to the First Hospital of Qinhuangdao from August 2017 to August 2018 were enrolled. Patients were divided into control group and observation group according to random number table method, with 30 patients in each group. The control group was given conventional treatment such as lowering intracranial pressure, anticoagulation, improving microcirculation, neurotrophy and anti-stress ulcer, while the observation group was received mild hypothermia (after 72 hours of treatment at 32-35 ℃, it increased about 1 ℃ every 6 hours until the normal temperature). The neurological impairment (the National Institutes of Health Stroke Scale, NIHSS), motor function (Fugl-Meyer score), daily living ability (Bathel index) and coma degree (Glasgow coma scale, GCS) were observed before treatment and 72 hours after treatment. The levels of plasma malondialdehyde (MDA), superoxide dismutase (SOD) and advanced oxidative protein products (AOPP) were measured at same time. After 72 hours of treatment, the therapeutic effect was judged according to the NIHSS score. Results There was no significant difference in NIHSS score, Fugl-Meyer score, Bathel index and GCS scores, and the levels of plasma MDA, SOD and AOPP between two groups before treatment. Compared with before treatment, NIHSS score and plasma MDA and AOPP levels in the two groups were significantly decreased after treatment, while Fugl-Meyer score, Bathel index, GCS score and plasma SOD activity were significantly increased; and the change of observation group was more significant than those of control group [NIHSS score: 9.78±3.24 vs. 13.44±2.63, MDA (mmol/L): 8.70±2.79 vs. 10.50±3.81, AOPP (μmol/L):51.10±17.81 vs. 72.60±18.71, Fugl-Meyer score: 55.68±8.38 vs. 46.25±3.92, Bathel index: 66.63±11.25 vs. 56.71±10.81, GCS score: 13.78±1.31 vs. 10.49±1.03, SOD (kU/L): 134.70±29.87 vs. 104.60±25.75, all P < 0.05]. The total effective rate of the observation group was significantly higher than that of the control group [93.3% (28/30) vs. 86.7% (26/30), χ2 = 6.119, P = 0.020]. Conclusions Mild hypothermia was effective in treating acute massive cerebral infarction. It could significantly improve the neurological function and oxidative stress of patients, improve the quality of life, and was safe and reliable.
