摘要
目的探讨复合支链氨基酸(BCAA)对严重烧伤患者营养代谢、免疫功能及炎症反应的影响,分析其在不同程度烧伤患者中的作用差异。方法纳入2024年1月—2025年3月收治的45例严重烧伤患者,随机分为观察组和对照组,每组完成研究各20例(重度/特重度分别10/10例、12/8例)。2组均接受基础治疗及常规营养支持,观察组加用含BCAA的肠外营养。比较2组治疗21 d的营养指标、免疫指标及炎症因子指标。结果治疗期间,观察组营养指标:血红蛋白(Hb)、白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)、球蛋白(GLB)较对照组显著改善,尿素氮(BUN)水平降低(P<0.05);免疫功能方面:观察组CD3+、CD4+比例、CD4+/CD8+比值显著高于对照组,CD8+比例显著低于对照组(P<0.05);炎症因子方面:观察组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平显著低于对照组(P<0.05)。上述效应在重度与特重度烧伤患者中均存在,但重度烧伤患者呈现早期合成代谢优势与炎症快速缓解,特重度烧伤患者表现为持续干预下的免疫重建与炎症滞后改善。结论BCAA可改善严重烧伤患者的营养状态、增强免疫功能并减轻炎症反应,为精准营养支持提供分层干预依据,且安全性良好。
Objective To explore the effects of branched-chain amino acids(BCAA)on the nutritional metabolism,immune function,and inflammatory response in patients with severe burns,and to analyze the differences in their effects among patients with varying degrees of burns.Methods A total of 45 severe burn patients,who were admitted into our hospital from January 2024 to March 2025 were enrolled.The patients were randomly divided into two groups(n=20):an observation group and a control group.Both groups were subjected to standard treatment and routine nutritional support,while the observation group additionally received parenteral nutrition containing BCAA.Nutritional indicators,immune indicators,and inflammatory factors were compared between the two groups after 21 days of treatment.Results During the treatment,the observation group showed significant improvements in nutritional indicators including hemoglobin(Hb),albumin(ALB),prealbumin(PA),transferrin(TRF),and globulin(GLB),as well as a reduction in blood urea nitrogen(BUN)levels(P<0.05),compared with the control group.For immune function,the observation group showed significantly higher proportions of CD3+,CD4+cells,and CD4+/CD8+ratio,and a significantly lower proportion of CD8+cells than the control group(P<0.05).In terms of inflammatory factors,the levels of high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factorα(TNF-α),and interleukin 6(IL-6)in the observation group were significantly lower than those in the control group(P<0.05).These effects were observed in both severe and very severe burn patients,but with different manifestations:severe burn patients exhibited early advantages in synthetic metabolism and rapid relief of inflammation,while very severe burn patients showed immune reconstruction and delayed improvement in inflammation under continuous intervention.Conclusions BCAA supplementation can improve the nutritional status,enhance immune function,and reduce inflammatory response in patients with severe burns.It is safe for use and provides evidence for precision nutrition support with stratified interventions.
作者
张方
崔庆伟
王培培
唐浩
孙晗
庄梦梦
张盼
李丹
陈文娣
孙勇
ZHANG Fang;CUI Qingwei;WANG Peipei;TANG Hao;SUN Han;ZHUANG Mengmeng;ZHANG Pan;LI Dan;CHEN Wendi;SUN Yong(Department of Burn Plastic Surgery,Huaihai Hospital Affiliated to Xuzhou Medical University,the 71st Group Military Hospital of the Chinese People′s Liberation Army,Xuzhou,Jiangsu 221000,China)
出处
《徐州医科大学学报》
2025年第7期518-523,共6页
Journal of Xuzhou Medical University
基金
国家自然科学基金(82302798)
江苏省卫生健康委医学科研项目面上项目(M2024032)
陆军第七十一集团军医院院内重点课题(YNZD-2022002)。
关键词
严重烧伤
复合支链氨基酸
营养
免疫功能
炎症反应
分层干预
severe burns
branched-chain amino acids
nutrition
immune function
inflammatory response
stratified intervention
作者简介
通信作者:孙勇,E-mail:sunyong_97@163.com。
