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目的研究老年人急性脑出血后局部亚低温治疗对其应激激素的影响。方法将96例老年脑出血患者随机分为局部亚低温组(47例)和常规治疗组(49例),常规治疗组单纯药物综合治疗,局部亚低温组在药物综合治疗基础上加用局部亚低温治疗,观察两组入院时、治疗后1w血浆促肾上腺皮质释放激素(CRH)、肾上腺皮质激素(ACTH)、皮质醇(Cor)的变化以及应激性疾病的改变。结果两组经治疗1w后,应激激素(ACTH、CRH、Cor)明显下降(P<0.05),应激性疾病(高血压、高血糖和应激性溃疡)明显好转(P<0.05);但同常规治疗组相比,局部亚低温组对应激激素和应激性疾病的影响更明显(P<0.05);同样,在应激性高血糖组也得到了相同的结果。结论颅脑局部亚低温治疗可稳定下丘脑垂体肾上腺(H P A)轴,显著降低脑出血的应激反应,改善应激性疾病。
Objective To investigate the effect of local mild hypothermia on the stress hormones in the elderly after acute cerebral hemorrhage. Methods Ninety-six elderly patients with cerebral hemorrhage were randomly divided into local mild hypothermia group (n = 47) and conventional treatment group (n = 49). The conventional treatment group was treated with simple drug therapy. The local mild hypothermia group was treated with local drug combination therapy Hypothermia was used to observe the change of plasma adrenocorticotropic hormone (CRH), adrenocorticotropic hormone (ACTH) and cortisol (Cor) at 1w after treatment and stress-induced changes in both groups. Results The stress hormones (ACTH, CRH, Cor) were significantly decreased (P <0.05) and the stress diseases (hypertension, hyperglycemia and stress ulcer) were significantly improved after 1 w of treatment (P <0.05). Compared with the conventional treatment group, the local mild hypothermia group had more significant effects on stress hormones and stress diseases (P <0.05). Similarly, the same results were obtained in the stress hyperglycemia group. Conclusion Local mild hypothermia treatment can stabilize the hypothalamic pituitary adrenal (H P A) axis, significantly reduce the stress response of cerebral hemorrhage, and improve stressful diseases.