支链氨基酸对脓毒性脑病神经元特异性烯醇化酶含量的影响
Effect of branched chain amino acid on the content of neuron specific in sepsis associated encephalopathy

黄永光.支链氨基酸对脓毒性脑病神经元特异性烯醇化酶含量的影响[J].内科急危重症杂志,2017,23(3):

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中文关键词: 脓毒性脑病（SAE）神经元特异性烯醇化酶(NSE) 支链氨基酸（BCAAs）

英文关键词:Neuron specific enolase Sepsis associated encephalopathy Branched chain amino acid

基金项目:2016年佛山市科技局医学科研项目（2015AB00369）

作者	单位	E-mail
黄永光	广东省佛山市第二人民医院（南方医科大学附属佛山医院）	huangyongguangys@163.com

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中文摘要:

目的:脓毒性脑病（SAE）的治疗效果并不理想，探索新颖的治疗策略非常需要。支链氨基酸对SAE的治疗效果还存在争议，本文探究支链氨基酸（BCAAs）是否可以通过下调神经元特异性烯醇化酶（NSE）含量，从而在治疗SAE时，达到有更好的治疗效果。方法:本文将本院ICU病房收诊的SAE患者随机地分成2组，分别是BCAAs治疗组（n=40）与常规治疗组（n=42）进行实验，常规治疗组是通过接受SAE指南指导的综合策略进行干预，BCAAs治疗组的治疗策略是常规组策略加上BCAAs进行干预。结果:2组患者的基线资料，性别比例，年龄，急性生理和慢性健康评分II，GCS评分统计学上无显著差异，基线资料基本一致，可以进行实验比较。我们对患者神经精神状况做了GCS评分，在治疗策略干预14天后，2组评分得分均有显著恢复，BCAAs组GCS评分得分在统计学差异上明显高于常规组；2组患者血清炎症指标均有明显的改善并下调，2组之间没有显著的不同；我们检测2组的NSE含量在第7天和14天存在统计学差异，BCAAs组的含量显著低于常规组。结论:支链氨基酸（BCAAs）可以通过下调NSE的含量，在治疗SAE时，能达到更好的治疗效果。从而，说明BCAAs可以在SAE的治疗中有着一定的疗效，在临床SAE的治疗中，BCAAs可以做为一种有效的干预措施，为SAE的治疗提供了新的方法和新思路。

英文摘要:

Objective: Sepsis associated encephalopathy (SAE) is a common clinical emergency in the Department of medicine ICU ward. This paper explores the effect of branched chain amino acid (BCAAs) in the treatment of SAE. And further explore the effect of BCAAs on the levels of neuron-specific enolase (NSE) in patients with SAE. Methods:This study was approved by the Local Ethics Committee. Total 82 patients with SAE were enrolled in this study and provided informed consent forms to participate.Subjects were randomly divided into BCAAs treatment group (n = 40) and routine treatment group (n = 42), the patients in the conventional treatment group accepted guidelines recommend comprehensive treatment, BCAAs treatment group not only accept treatment guidelines recommend, and BCAAs injection 250ml/day, intravenous infusion of less than or equal to 40 drops per minute treatment. Results: after treatment for 14 days, GCS scores of the 2 groups was significantly improved, compared with the conventional treatment group, BCAAs treatment group patients with GCS score were significantly increased (P < 0.05); serological markers of inflammation (white blood cell count, addicted to the neutrophilic granulocyte count, CRP, ESR, TNF - levels) 2 group of patient level were significantly decreased, but no significant differences between the two groups; the levels of NSE, LDH, LA in cerebrospinal fluid, group 2 were significantly decreased, in BCAAs treatment group were significantly lower than in conventional treatment group (P < 0.05). Conclusion: The levels of NSE in both serum and cerebrospinal fluid were significantly increased in SAE patients, BAACs treatment not only improved the GCS score and to accelerate the reduction of the content of NSE in both serum and CSF, and in SAE clinical treatment BAACs treatment has a certain curative effect in the treatment of SAE. BAACs can be as an effective intervention measures, this study provides new ideas and new methods for the treatment of SAE.