摘要
目的探讨ω-3多不饱和脂肪酸对重型颅脑损伤患者炎症反应、神经损害及预后的影响。方法2013年1月至2014年9月福建中医药大学附属晋江中医院收治的重型颅脑损伤患者120例，随机数字表法随机分为试验组（添加ω-3脂肪酸脑损伤组60例）和对照组（未添加ω-3脂肪酸脑损伤组60例）。另选择60份健康体检血液标本作为健康人群组。利用酶联免疫吸附测定法检测血清肿瘤坏死因子（TNF）-a、自细胞介素（IL）-1、IL-6、S100B蛋白和神经元特异性烯醇化酶（NSE）浓度，比较两组患者格拉斯哥昏迷指数评分（GCS评分）、急性生理学及慢性健康状况（APACHEⅡ）评分和预后。结果重型颅脑损伤患者伤后各时点血清TNF—a、IL-1、IL-6和神经损伤标志物S100B和NSE蛋白表达明显高于健康人群组（均P〈0．05）。试验组患者在干预3d后TNF-α、IL-1、IL-6表达明显低于对照组患者[（213．81±29．33）μg/L比（267．76±31．35）μg/L，（121．81±10．63）μg／L比（152．60±11．45）μg/L，（81．89±8．34）μg/L比（106．62±10．35）μg／L，均P〈0．05]，S100B和NSE蛋白表达在干预7d后表达低于对照组[（1．32±0．09）μg/L比（1．67±0．12）μg/L，（12．57±1．53）μg/L比（17．57±2．30）μg／L，均P〈0．05]；在干预第14天时，试验组GCS评分高于对照组[（9．32±1．64）分比（7．14±1．30）分，P=0．02]，APACHEII评分低于对照组[（14．37±2．27）分比（17．00±1．85）分，P=0．04]。随访1个月时，试验组病死率低于对照组[11．7％（7／60）比15．0％（9／60）]，但差异无统计学意义（P=0．49）。结论对重型颅脑损伤患者，ω-3不饱和脂肪酸可通过减轻伤后炎症反应，减少神经胶质和神经元细胞损害，起到神经保护作用，值得临床推广应用。
Objective To investigate the effects of omega-3 polyunsaturated fatty acids （ω-3 PUFA） on inflammatory response, nerve damage, and outcomes in patients with severe traumatic brain injury （ sTBI ）. Methods Altogether 120 sTBI patients were selected from January 2013 to September 2014 in Jinjiang Hospital of Traditional Chinese Medicine and divided with a random number table into experimental group （ with ω-3 PUFA supplementation, n = 60） and control group （without ω-3 PUFA supplementation, n = 60）. Sixty blood samples from healthy people visiting the physical examination clinic were collected as normal controls. The serum levels of tumor necrosis factor-a （TNF-α）, interleukin （IL）- 1, IL-6, S100B and neuron-specific enolase （NSE） were detected with enzyme-linked immunosorbent assay （ELISA）. Glasgow Coma Scale （GCS） score, Acute Physiology and Chronic Health Evaluation （APACHE） Ⅱ score and outcomes of the two groups werecompared. Results The serum levels of TNF-α, IL-1, IL-6, S100B, and NSE protein significantly increased in patients with sTBI compared with the normal controls （ all P 〈 0. 05 ）. Compared with the control group, the serum levels of inflammatory related factors （TNF-α, IL-1, IL-6） in the experimental group were significantly decreased on the 3rd day [ （ 213.81 ± 29. 33 ） μg/L vs. （ 267.76 ± 31.35 ） μg/L, （ 121.81 ± 10. 63 ） μg/L vs. （ 152. 60 ± 11.45 ） μg/L, （81.89 ± 8.34） μg/L vs. （ 106. 62 ± 10. 35 ） μg/L, all P 〈 0.05 ], S100B and NSE protein expressions were significantly decreased on the 7th day [ （ 1.32 ± 0.09 ） μg/L vs. （ 1.67 ± 0. 12） μg,/L, （ 12. 57 ± 1.53 ） μg/L vs. （ 17.57 ± 2. 30） μg/L, both P 〈 0. 05 ]. Compresd with the control group, the experimental group showed significantly higher GCS scores （9. 32 ± 1.64 vs. 7.14±1.30, P = 0. 02） and significantly lower APACHE Ⅱ scores （ 14. 37 ±2. 27 vs. 17.00 ± 1.85, P =0. 04） on the 14th day. Compresd with the c
出处
《中华临床营养杂志》
CAS
CSCD
2015年第4期224-228,共5页
Chinese Journal of Clinical Nutrition
关键词
重型颅脑损伤
Ω-3多不饱和脂肪酸
炎症反应
神经保护
Severe traumatic brain injury
Omega-3 polyunsaturated fatty acids
Inflammatory response
Neuroprotection
