ω-3脂肪酸对重型颅脑损伤术后病人T细胞亚群和预后的影响

The effect of ω-3 fatty acids immunonutrition on T-cell subgroup and outcome of traumatic brain injury patients

目的:观察早期肠内营养中添加ω-3脂肪酸对重型颅脑损伤病人术后的治疗效果。方法:将45例重型颅脑损伤手术病人随机分成试验组和对照组,根据病情需要,对病人行开颅手术治疗后,分别行早期肠内免疫营养和早期常规肠内营养,进行等热量和等氮量的营养支持。在手术前、术后第7和第15天测定T细胞亚群、淋巴细胞总数、血清清蛋白水平,并统计感染并发症的发生率,比较两组病人术后第15天格拉斯哥昏迷(GCS)评分和术后3个月的预后(GOS)评分情况。结果:与对照组比,试验组病人T细胞亚群和淋巴细胞总数明显回升,感染并发症的发生率下降,术后第15天GCS评分增高(P<0.05)。试验组病人预后较好者GOS评分明显高于对照组(P<0.05)。血清清蛋白水平两组无统计学差异。结论:应用ω-3脂肪酸免疫营养支持能改善病人的营养状况,提高免疫功能,降低感染率,改善预后。

Objective： To observe the therapy effect of early enteral immunonutrition with Omega-3 fatty acids in traumatic brain injury patients after operation.Methods： 45 patients with traumatic brain injury were randomized into two groups by hospital order：research group（n=23,immunonutrition） and control group（n=22,regular nutrition）.Each patient was underwent an operation depending on patient＇s condition.All patients were given an isocaloric and isonitrogenous diet after operation with early enteral nutrition.The variables（T-cell subsets,total lymphocytes,albumin） were measured before and day 7 and 15 after operation.The rate of infectious complication and the GCS score 15 days after opertion were also recorded.Results： Compared with the control group,the T-cell subset level,the total lymphocytes and the GCS score 15 days after opertion were higher and the rate of infectious complication was lower（P〈0.05） in research group.The grades 4 and 5 of the GOS had significant difference between the research group and control group（P〈0.05）.Albumin was not obviously different between two groups.Conclusion： Immunonutrition with ω-3 fatty acids after operation can improve nutritional condition and immune function,decrease the rate of infectious complication and improve the prognosis in severe traumatic brain injury patients.