| A Study on the Effection of Moderate Hypothermia on Cerebrospinal FluidTumor Necrosis Factor a , lnterleukin-6 and lnterleukin-8 Levels andTherapy Mechanism After Severe Traumatic Brain Injury in Humans[Background] Traumatic brain injury is a very commom disease of neurosurgery. Especially, the severe traumatic brain injury(sTBI) has a very high mortality and morbidity.which is very a severe threaten to human health,so that is a important issue and difficult to be resolved in the field of neurosurgery .We found the Cytokines had played a very important role in the research of sTBI mechanism.Cytokines has taken part in process of inflammation response and biochemical metabolism post-traumatic brain injury.A great deal of Cytokines can secrete and release in the conditions of stress such as inflammation,traumat,other serious disease and so on.The investigation of the methods of suppress the over-expression have been a focus.Since 1950~60s in 20 century.lots of neurosurgical clinical investigators have treated the sTBI with the mild and moderate hypothermic therapy(HT) and achieved a good outcome.Since 1990s,the report that the HT could decrease the mortality of sTBI,recover the neuronal f unctions.improve the clinical outcome.We found the treatment of moderate hypothermia could significantly suppress the over-expression of Cytokines, decrease the post-traumatic vasogenic inflammatory response, decrease the level of the ICP, protect brain tissues, improve the clinical prognosis.[Objective] In order to research on the effection of moderate hypothermia on cerebrospinal fluid tumor necrosis factor a (TNFa),interleukin-6(IL-6)and interleukin-8(IL-8) levels and therapy mechanism after severe traumatic brain injury in humans.[Methods] The 5ml cerebrospinal fluid of the 82 patiens with sTBI[divided randomly into HT group and 40 normothermic group(NT,group)] and the 20 normal control person(Nor,groups)were collected in this experiment. All of patients, ventricular CSF had been collected on five different time point including 1 hour pre-HT,12 and 24 hour post-HT,24 hour post-rewarming and 1 month post-injury using ventriculopuncture. The level of TNFa,IL-6 and IL-8 in CSF was mensurated by radioimmunoassay and the relationship among clinical parameters such as ICP.GCS and GOS were analyzed.the correlation and difference of sex.age factors were discussed elementarily.We had researched the effection and therapeutic mechanism of Moderate Hypothermia on patients with sTBI.[Results] As a result:(1) The TNFa,IL-6 and IL-8 concentrations of sTBI groups were significant higher than Nor groups in the early post-injury.There was a over-expression trend of the TNFa,IL-6 and IL-8 in post-sTBI.(2) The level of TNFa appeared earlier to increase.the IL-6 sustained in higher level during the longest time.the IL-8 decreased quickly to normal range.it was different change in different cytokines and may make a clinical sign to disease.(3) The content of TNFa,IL-6 and IL-8 began to decrease from 12 to 24 hour after moderate hypothermia therapy.and sustained until rewarming period and 1 month post-sTBI,the results show the moderate hypothermia can significantly suppress the overexpression of Cytokines.(4)There was positive correlation between the content of TNFa,IL-6,IL-8 and ICRthe moderate hypothermia can decrease significantly ICP value in sTBI groups and may play the role bysuppressing the elevated cytokines.(5) We found that the earlier began to treat sTBI with the moderate hypothermia(within 24 hours),the significantly lower content of TNFa,IL-6 and IL-8, the lower ICP level,and the better outcome.(6)The treatment of moderate hypothermia can decrease the mortality(23.81%),increase the rate of good recovery(59.53%),improve the clinical prognosis,it is a safe and reliable therapy method.(7) There were negative correlations between the content of TNFa,IL-6 and prognosis,but there was no any correlation with IL-8.So there were some associations of Cytokines and prognosis.the moderate hypothermia may improve the clinical outco... |
PDF Full Text Request