-3多不饱和脂肪酸在颅脑外伤并发肺部感染治疗中的应用

    Role of -3 polyunsaturated fatty acids in treatment of severe brain injuRy accompanied by lung infection

    • 摘要: 目的:观察-3多不饱和脂肪酸(-3 PUFAs)在重度颅脑外伤并发肺部感染治疗中的应用效果。方法:将56例重度颅脑外伤并发肺部感染的患者随机分为对照组(A组)和-3 PUFAs组(B组),B组治疗中加用-3 PUFAs。2组患者均完善相关检查,给予抗感染、脱水降颅压等常规治疗,均建立人工气道(气管插管或气管切开)及机械通气,给予能量补充105~125 kJkg-1d-1,其中B组中部分热量由含-3脂肪酸的脂肪乳剂来提供。分别于治疗前及治疗第2、4、7天监测患者当天白细胞计数、C反应蛋白、淋巴细胞亚群分类,并使用ELISA法检测肺泡灌洗液中肿瘤坏死因子-(TNF-)、白细胞介素(IL)-6及IL-10的水平。结果:肺泡灌洗液中TNF-的表达水平在第4、7天B组均明显低于A组(P0.01)。肺泡灌洗液中IL-6的表达水平在第7天B组显著低于A组(P0.01)。肺泡灌洗液中IL-10的表达水平差异无统计学意义(P0.05)。白细胞水平在第4、7天B组均低于A组(P0.01)。CRP水平在第2、4、7天B组均低于A组(P0.01)。CD4/CD8比值在第2、4、7天B组均高于A组(P0.01)。结论:-3 PUFAs能够调节重度颅脑外伤并发肺部感染患者的免疫状态,对肺脏有一定保护作用。

       

      Abstract: Objective:To obseRve the effect of -3 polyunsatuRated fatty acids in tReatment of seveRe bRain injuRy complicated by lung infection.Methods:Fifty-six cases of seveRe bRain injuRy accompanied by pulmonaRy infection weRe Randomly divided into contRol gRoup(gRoup A) and -3 polyunsatuRated fatty acids gRoup(gRoup B).GRoup B weRe administeRed -3 polyunsatuRated fatty acids in addition to the Routine theRapy.All the patients weRe given Relevant examinations and tReatment such as antibiotics,Reducing the intRacRanial pRessuRe,endotRacheal intubation,ventilatoR application and post-tRacheotomy.Both gRoups weRe given eneRgy supplement 105-125 kJkg-1d-1,but in gRoup B,some of the heat was pRovided by the fat emulsion of -3 polyunsatuRated fatty acids.On the 0th,2 nd,4 th and 7th day,the patients' white blood cell(WBC),C Reactive pRotein(CRP) and lymphocyte subsets classification weRe monitoRed; and the tumoR necRosis factoR-(TNF-),inteRleukin-6(IL-6) and IL-10 weRe tested in the lavage fluid by enzyme linked immunosoRbent assay.Results:The expRession of TNF- in the lavage fluid of gRoup B on the 4th and 7th day was significantly loweR than that of the contRol gRoup(P 0.01); the expRession of IL-6 in the lavage fluid of gRoup B on the 7th day was significantly loweR than that of the contRol gRoup(P 0.01); the expRession of IL-10 in the lavage fluid of the two gRoups was not statistically diffeRent(P 0.05).The WBC level of gRoup B on the 4th and 7th day was significantly loweR than that of the contRol gRoup(P 0.01); the CRP level of gRoup B on the 2nd,4th and 7th day was significantly loweR than that of the contRol gRoup(P 0.01); the CD4/CD8 Ratio of gRoup B on the 2nd,4 th and 7th day was significantly higheR than that of the contRol(P 0.01).Conclusions:-3 polyunsatuRated fatty acids can impRove the immunity of patients with seveRe bRain injuRy complicated by lung infection and have a pRotective effect on the lung.

       

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