Liang Cheng, Wang Ji-zuo, Li Xin
Department of Neurology, Second Affiliated Hospital of Tianjin Medical University, Tianjin, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2008 Aug;28(9):1696-9.
To investigate the changes in stress hormones in neurogenic pulmonary edema (NPE) and explore the clinical value of mild hypothermia therapy for treatment of NPE.
Fifty-two patients with cerebral hemorrhage patients and concomitant NPE were randomly divided into two groups for local mild hypothermia therapy (23 cases, LMH group) or routine treatment (29 cases, RT group). In the former group, local mild hypothermia therapy was applied in addition to the routine treatment. The changes of serum corticotrophin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), corticosteroid (Cor), arginine vasopressin (AVP) and blood sugar were observed before and 7 days after the treatment, and compared with those of 58 NPE-free patients with cerebral hemorrhage and 40 healthy individuals.
Serum CRH, ACTH, Cor, and AVP levels and blood sugar in NPE patients and the NPE-free patients were all significantly higher than those in the healthy individuals (P<0.01), and the levels were significantly higher in NPE patients than in the NPE-free patients (P<0.05). In the NPE patients, the mortality rate and NIHSS score were significantly lower in RT group (P<0.01); after 7 days of treatment, both LMH and RT groups showed significant reduction in serum CRH, ACTH, Cor, and AVP levels (P<0.05), and the reduction was more conspicuous in LMH group (P<0.05).
The occurrence of NPE is closely associated with stress reactions, which might be the basis of NPE. Local mild hypothermia therapy improves of the quality of life of NPE patients and also decreases the mortality of NPE possibly by inhibiting the secretion of stress hormones and stabilizing the hypothalamic-pituitary-adrenal axis.
