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目的观察亚低温疗法对重症病毒性脑炎患儿血清和脑脊液中基质金属蛋白酶(MMPs)的干预作用。方法 120例患儿随机分为实验组和对照组,每组60例。给予所有患儿抗病毒、对症等常规治疗。实验组患儿在常规治疗的基础上,加用5 d的选择性头部亚低温治疗。于治疗前、治疗中(第3天)和治疗后(第7天),测定和比较两组患儿血清和脑脊液中基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)的浓度。结果所有患儿血清和脑脊液中MMP-2和MMP-9的浓度都呈3 d后达到高峰、7 d明显下降的趋势。经过亚低温疗法的干预,实验组患儿血清和脑脊液中MMP-2和MMP-9的浓度在治疗中和治疗后均明显低于对照组患儿(P<0.01)。结论选择性头部亚低温疗法可明显抑制重症病毒性脑炎患儿血清和脑脊液中MMP-2和MMP-9的释放。
Objective To investigate the effects of mild hypothermia on matrix metalloproteinases (MMPs) in serum and cerebrospinal fluid in children with severe viral encephalitis. Methods 120 cases of children were randomly divided into experimental group and control group, 60 cases in each group. Give all children anti-virus, symptomatic and other conventional treatment. The experimental group of children on the basis of conventional treatment, plus 5 d of selective head mild hypothermia. The levels of MMP-2 and MMP-9 in serum and cerebrospinal fluid (CSF) were measured and compared before treatment, during treatment (day 3) and after treatment (day 7) 9) concentration. Results The levels of MMP-2 and MMP-9 in serum and cerebrospinal fluid of all children peaked at 3 days and decreased significantly at 7 days. The levels of MMP-2 and MMP-9 in the serum and cerebrospinal fluid of the experimental group were significantly lower than those in the control group (P <0.01) after the treatment of mild hypothermia therapy. Conclusion Selective head and neck hypothermia therapy can significantly inhibit the release of MMP-2 and MMP-9 in serum and cerebrospinal fluid of children with severe viral encephalitis.