The effect of body temperature in the acute phase of subarachnoid hemorrhage on the long term outcome

蛛网膜下腔出血急性期体温对远期预后的影响

• 批准号: 07671544
• 负责人: TAKAGI Kiyoshi
• 金额: $ 0.13万
• 依托单位: Teikyo Univ.School of Med.
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671544/
• 关键词: cerecrovascular disease; subarachnoid hemorrhage; temperature; hypothermia; outcome; subarachnoid hemmorrhage; クモ膜下出血; 体温; 予後; retrospectively study; WFNS分類

Background : In recent years, it has been disclosed experimentally and clinically that the brain temperature is one of the most important factors that decide the outcome of the brain disease. The purpose of this study is to evaluate the effect of the body temperature control in the acute phase of the subarachnoid hemorrage.Materials and Method : First, we developed a new SAH grading scale based solely upon the Glasgow Coma Scale and the standard outcome evaluated by Glasgow Outcome Scale with numerical translation (dead=1 to good recovery=5) for each grade. We investigated the relatioship between the SAH grade and the body temperature on the admission. Eight patients with SAH received temperature control therapy in the acute phase of the disease uwing cooling blanket to be kept at slightly hypothermic condition. The outcome was evaluated at 3 months after the onset.Results : A newly developed SAH grading is as follows ; I (GCS=15), II (GCS=11-14), III (GCS=8-10), IV (GCS=4-7), and V (GCS=3). Standard outcomes for each SAH grade are as follows respectively ; 4.68(]SY.+-。[)0.05,4.10(]SY.+-。[)0.06,3.55(]SY.+-。[)0.11,2.65(]SY.+-。[)0.10, and 1.81(]SY.+-。[)0.22. The outcome of the patients with temperature control did not exceed the standard outcome. The body temperature in the patients with low SAH grade was significantly lower than those with high SAH grade.Conclusion : These results suggest that the application of the hypothermia therapy to the patients with SAH must be done with great care in order to exceed the standard outcome.

背景：近年来，实验和临床研究表明，脑温度是决定脑病预后的重要因素之一。本研究旨在探讨体温控制在蛛网膜下腔出血急性期的作用。材料和方法：首先，我们开发了一个新的SAH分级量表，该量表完全基于格拉斯哥昏迷量表和格拉斯哥结局量表评估的标准结果，每个等级都有数字转换（死亡=1到良好恢复=5）。我们调查了入院时SAH等级与体温之间的关系。8例蛛网膜下腔出血患者在疾病急性期接受温度控制治疗，使用降温毯保持微低温状态。在发病后3个月评估结果。结果：新制定的SAH分级如下；我(GCS = 15),二(GCS = 11 - 14),三世(GCS = 8 - 10), IV (GCS = 4 - 7)和V (GCS = 3)。各SAH级别的标准结局分别如下：4.68 (SY。+ -。[0.05,4.10]SY。+ -。[0.06,3.55]SY。+ -。[0.11,2.65]SY。+ -。(0.10),和1.81 (SY。+ -。(0.22)。体温控制患者的预后未超过标准预后。低SAH分级患者的体温明显低于高SAH分级患者。结论：提示在SAH患者中应用低温治疗必须非常谨慎，才能达到超标准的疗效。

项目成果

Akira Tamura: "Clinical Pharmacology of Cerebral Ischemia" Ter Horst GJ and Korf J (eds) The Humara Press Inc, (1996)

Akira Tamura：“脑缺血的临床药理学”Ter Horst GJ 和 Korf J（编辑）The Humara Press Inc，（1996）

Akira Tamura, Kiyoshi Takagi, Kensuke Kawai: "Animal models used in cerebral ischemia and stroke research. Ter Horst GJ and Korf J (eds) Clinical pharmacology of cerebral ischemia." 265-294 (1996)

Akira Tamura、Kiyoshi Takagi、Kensuke Kawai：“用于脑缺血和中风研究的动物模型。Ter Horst GJ 和 Korf J（编）脑缺血的临床药理学。”

高木清: "脳血管攣縮 vol 12" 太田富雄、浅野孝雄 他 中外医学社(in press),

Kiyoshi Takagi：《脑血管痉挛第 12 卷》Tomio Ota、Takao Asano 等（正在出版），

Gotoh O,Tamura A,Yasui N,Suzuki A,Hadeishi H,Sano K: "Glasgow coma scale in the prediction of outcome after early aneurysm surgery" Neurosurgery. 39. 19-25 (1996)

Gotoh O，Tamura A，Yasui N，Suzuki A，Hadeishi H，Sano K：“格拉斯哥昏迷量表在预测早期动脉瘤手术后的结果中”神经外科。

Gotoh O: "Glasgow Coma Scule in the Prediction of Outcome after Eary Aneurysm Surgery" Neurosurgery. 39. 19-25 (1996)

Gotoh O：“格拉斯哥昏迷 Scule 在预测耳动脉瘤手术后的结果”神经外科。