颅脑损伤后蛋白质代谢和免疫功能的变化及意义

Effect of craniocerebral trauma on protein metabolism and immune function

目的 对严重颅脑损伤后机体蛋白质代谢的情况进行分析。方法 动态观测 2 2例严重颅脑损伤患者伤后 2周内的血清蛋白、血清氨基酸、氮平衡的变化 ,以及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 (1 6 .2 4± 5 .2 )g/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 ;伤后血前清蛋白、转铁蛋白和纤维连接蛋白立即下降 ,并持续 1 2天。结论颅脑损伤后即出现的营养不良 ,可同时影响T细胞亚群 ,使CD3+ 、CD4 + 、CD4/CD3 值明显降低 ,使伤员感染发生率和死亡率增加。因此 。

Objective To investigate the state of protein metabolism following severe craniocerebral trauma.?Methods The changes in serum protein,serum amino acid spectrum,nitrogen balance in 12 days following cerebral craniocerebral trauma and the effect on cellular immune function were dynamically observed.?Results After severe craniocerebral trauma,the average urinary nitrogen excretion was increased to(16.24±5.2)g/day, the spectrum of serum amino acids was disorganized,the concentration of total amino acids was decreased and the ratio of BCAA/AAA was decreased. Serum protein, transferrin and fibronectin were reduced immediately after trauma and lasted for 12 days.?Conclusion Craniocerebral trauma can result in malnutrition,influence T lymphocyte subtypes (CD3 + ,CD4 + ),decrease the ratio of CD 4 /CD 3 and finally increase the infectious morbidity and mortality rate of the patients.?Nutritional therapy should be strengthened on patients with severe craniocerebral trauma.