摘要
目的：了解严重脑外伤后机体蛋白质分解代谢的程度。方法：动态观察２０例严重脑外伤患者伤后１０天内的氮平衡、血清氨基酸谱、血清蛋白质的变化，和对细胞免疫功能的影响。结果：尿氮排出量增加，平均尿氮排出量为１６．２３±５．３４ｇ／ｄ；血清氨基酸谱紊乱，总氨基酸浓度下降及支链氨基酸和芳香氨基酸比值（ＢＣＡＡ／ＡＡＡ）下降；血清前清蛋白、转铁蛋白和纤维连接蛋白伤后立即下降，并持续１０天。结论：脑外伤早期即出现营养不良，并影响Ｔ细胞亚群，ＣＤ＋３、ＣＤ＋４、ＣＤ４／ＣＤ８值明显降低，使病人感染发生率和死亡率增加。因此有必要在脑外伤早期加强营养支持。
Aim: The study focused on evaluating the level of protein catabolism in severely head injured patients. Methods: Nitrogen balance, serum amino acid profiles, serum proteins and immune globulin, T cell subsets were detected in twenty patients suffering from severe head injury during the first 10 days after trauma. Results: These patients had an increased urinary nitrogen excretion with a mean urinary nitrogen excretion of 16.23±5.34g/d, an altered serum amino acid profiles, a rapid decrease in the concentration of nearly all amino acids, and the serum ratio of branched chain to aromatic amino acids (BCAA/AAA). The serum protein levels such as albumin, transferrin, prealbumin and fibronectin dropped soon after the trauma and lasted for the entire period. Conclusion: Malnutrition appeared in the early period after severe head injury. CD 3 and CD 4 cells decreased at day 4 and 10. The ratio of CD 4 to CD 8 also decreased. It is suggested that the patients with changes of T cell subsets become more suscepitible to infection and death. Thus, it is necessary to strengthen alimentotherapy for severely head injured patients in the early stage.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
1996年第2期76-78,共3页
Chinese Journal of Trauma
关键词
脑损伤
氨基酸代谢
细胞免疫
蛋白质代谢
Head injury Amino acid metabolism Cellular immunity Nutritional support
