【摘要】 目的:研究重型颅脑外伤(traumatic brain injury,TBI)后食物补充二十二碳六烯酸(docosa-4,7,10,13,16,19-hexaenoic acid,DHA)对重型TBI患者预后的影响。方法:将46例重型TBI患者,随机分成对照组(22例)和DHA治疗组(24例)。DHA治疗组患者伤后1周给予每日鼻饲或口服深海鱼油2 000 mg其中含DHA 320 mg,持续3个月。对照组患者不补充DHA,其余治疗同DHA治疗组。测定入院时及入院3个月时两组患者血DHA浓度。两组患者伤后3个月行格拉斯哥预后评分(Glasgow outcome scale,GOS),4~5分为治疗效果较好,1~3分为较差。结果:对照组患者入院时血DHA浓度为(20±0.273)pg/ml,治疗组患者为(20±0.269)pg/ml,两组患者差异无统计学意义(P=0.871)。对照组患者入院3个月时血DHA浓度为(19±0.236)pg/ml,治疗组患者为(31±0.279)pg/ml,两组患者差异有统计学意义(P<0.05)。入院时对照组患者的GCS平均为(8.70±4.04)分,治疗组患者为(9.09±3.83)分,两组患者间差异无统计学意义(P=0.460)。伤后3个月时,对照组患者治疗效果较好和较差的分别为6例(27%)和16例(72%),DHA治疗组患者为9例(37%)例和15例(63%)。两组患者间差异有统计学意义(P<0.05)。结论:血DHA水平对重型颅脑外伤患者预后有较明显的影响。更多还原

【Abstract】 Objective: To study effects of dietary supplementation with docosa- 4,7,10,13,16,19- hexaenoic acid( DHA)on prognosis of patients with severe traumatic brain injury( severe TBI). Methods: 73 patients with severe TBI were assigned randomly to receive DHA( DHA group,n = 24) or placebo( control group,n = 22) for 3 months. The therapy began 7 days after TBI,and320 mg / day DHA( from 2000 mg / day fish oil) was administered orally or through nasogastric feeding tube. The serum DHA concentrations of these patients at admission and 3 months after the treatment were measured. The prognosis was assessed by Glasgow Outcome Scores( GOS) at 3rd month: good recovery as GOS 4- 5 and poor recovery as 1- 3. Results: At admission,there was no significant statistical difference between DHA and control group with regarding to mean DHA levels( 20 ± 0. 273 vs. 20 ± 0. 269 pg / ml; P = 0.871) and GCS scored( 8. 70 ± 4. 04 vs. 9. 09 ± 3. 83; P = 0. 460). At the end of the treatment,the DHA level in DHA group was significantly higher than that in control group( 31 ± 0. 279 vs. 19 ± 0. 236 pg / ml,P < 0. 05). A higher percentage of good recovery was observed in DHA group compared with control group( 9 /24,37% vs. 6 /22,27%),and the difference was statistically significant( P< 0. 05). Conclusions: The serum DHA levels are associated with better prognosis in the severe TBI patients.更多还原