Effective Of Mild Hypothermia On Myelin Basic Protein And T Lymphocytes In TBI Patients

Objective：study the influence of mild hypothermia on the level of MBP and CD4+and CD8+T cell in cerebrospinal fluid of TBI patients in different time point byrandomization. In our clinical test, we analyzed the effective of mild hypothermia onmyelin basic protein（MBP）and immune function of TBI, in order to investigate thepossible mechanisms of mild hypothermia neuroprotection, provide the evidence ofdeepgoing clinical application of mild hypothermia.Methods：36cases of severe brain injury patients were subjected to2groupsrandomly. We collected specimen of cerebrospinal fluid by intracranial pressuremonitoring system of external ventricular drainage（EVD） in1d,7d and14d by lumbarpuncture after treatment, detected the variation of MBP and CD4+and CD8+T cell indifferent time point. Discriminatory analysis the influence of mild hypothermia on TBIbinding with the variation of intracranial pressure and prognosis.Results：1. compared with control group, relative amount of CD4+T cell increasedsignificantly（P＜0.05）,and relative amount of CD8+T cell decreased significantly（P＜0.05）.2.There are no difference of the lever of MBP between two groups in1d aftertreatment（P﹥0.05）, and There are significant difference7d,14d after treatment（P＜0.05）,at the same time point, relative amount of CD4+T cell increased significantly（P＜0.05）, CD8+T cell decreased significantly（P＜0.05）.3. There are no difference ofintracranial pressure（ICP） after injury（P﹥0.05）, and There are significant difference7d,14d after injury（P＜0.05）.4. Binding with GOS, compared with prognosis, there are8cases of good prognosi（s40%）,3cases of mid-handicap（15%）,8cases of highly handicap（25%）,1cases of vegetative state（5%）,3cases of death（15%）in hypothermia team.There are4cases of good prognosis（25%）,1cases of mid-handicap（6.25%）,5cases ofhighly handicap（31.6%）,3cases of vegetative state（18.8%）,3cases of death（18.8%）in control team. There are significant difference in prognosis（P＜0.05）, but There are no difference of death rate （P﹥0.05）.Conclusion:1. Mild hypothermia may provide neuroprotection by reduce degradation of MBPand prevent the second brain injury.2. Mild hypothermia can increase relative amount of CD4+T cell and decreaseCD8+T cell in cerebrospinal fluid in brain injuried patients.3. Mild hypothermia may provide neuroprotection by reduce degradation of MBP,degrade extremist immune response, accommodate T cell immunity, suppressInflammatory reaction after injury.