早期肠内营养对急性重型颅脑损伤患者血清C反应蛋白浓度的影响  

Plasma C-reactive protein levels in patients with acute severe brain injury undergoing early enteral nutrition

作　　者：周央环[1] 陈再丰[2] 

机构地区：[1]慈溪市人民医院内科,315300 [2]慈溪市人民医院内科神经外科,315300

出　　处：《浙江医学》2012年第12期999-1001,共3页Zhejiang Medical Journal

基　　金：浙江省卫生厅科技计划项目（2010KYA176）

摘　　要：目的 通过动态观察早期肠内营养（EEN）对急性重型颅脑损伤患者血清C反应蛋白（CRP）浓度的影响,探讨EEN在急性重型颅脑损伤治疗中的作用.方法 将120例急性重型颅脑损伤患者随机分为EEN组和早期肠外营养（PN）组.入院48h内给予不同方法的营养支持.所有患者于入院6h内及入院后第2、4、6、8、14天应用速率放射比浊法动态检测血清CRP浓度.并将体检的正常成年人30例作为对照组.结果 EEN和PN组血清CRP浓度明显高于对照组（P＜0.05）;EEN和PN组伤后第2天血清CRP浓度达到峰值,随着时间推移两组患者血清CRP浓度均呈下降趋势,但EEN组下降幅度更明显,伤后第4、6、8及14天EEN组血清CRP含量均明显低于PN组（P＜0.05或0.01）.结论 急性重型颅脑损伤后血清CRP浓度升高,EEN可保护重型颅脑损伤患者的胃肠道黏膜,减轻其全身炎症反应,改善神经功能.Objective To investigate plasma C-reactive protein （CRP） levels in patients with acute severe brain injury undergoing early enteral nutrition （EEN）. Methods One hundred and twenty patients with acute severe brain injury were ran- domly divided into EEN group and early parenteral nutrition （PN） group. The nutrition support was given to all the patients within 48h after admission to the hospital. Thirty healthy subjects served and normal controls. Sequential serum CRP levels were mea- sured by rate nephenometry in normal control and patients at 6h, 2, 4, 6, 8 and 14d after the injury. Results Serum CRP levels in brain injury patients were significantly higher than those of normal controls （P〈0.05）; in patients serum CRP levels reached to the peak value in 2d after injury, then gradually decreased. Serum CRP levels were significantly lower in the EEN group at 4, 6, 8 and 14 d after injury than those in PN group at the same time points （P〈0.05 or P〈0.01）. Conclusion The serum CRP levels are elevated significantly after acute severe brain injuries. EEN can decrease CRP levels, which indicates that it may protect the gastro-intestinal mucous membrane and reduce systemic inflammatory reaction in patients with acute severe brain injury.

关 键 词：早期肠内营养 急性重型颅脑损伤 C反应蛋白 

分 类 号：R651.15[医药卫生—外科学]