不同程度创伤性脑损伤后肠黏膜屏障功能的变化

目的 探讨不同程度创伤性脑损伤(TBI)后肠黏膜屏障功能的变化.方法 将我院2009年6月～2010年12月收治的50例TBI患者根据入院时格拉斯哥昏迷评分(GCS)分为轻度(n=18),中度(n=18),重度(n=14)3组;30例健康成年体检者为对照组,观察比较其伤后3、12、24小时和72小时血浆二胺氧化酶(DA...

Changes of intestinal mucosa barrier following graded traumatic brain injury

Objective To investigate the changes of intestinal mucosa barrier following graded traumatic brain injury.Methods A prospective study was carried out in 50 patients who suffered from traumatic brain injury(TBI) from Jun.2009 to Dec.2010.According to GCS,the 50 patients who suffered from TBI were divided into 3 groups: mild TBI group(n=18),moderate TBI group(n=18),severe TBI group(n=14).And the 30 healthy individuals were taken as control group.Plasma levels of diamine oxidase(DAO),D-lactate(D-LAC) and endotoxin(ET) in 30 healthy individuals and 50 patients who suffered from TBI at 3,12,24 and 72 hours after trauma were measured.Results In mild TBI group,the activity of DAO,the level of D-LAC and ET at 24 hours post-injury were significantly higher than those in control group,respectively(P<0.01).At 72 hours post-injury,they all decreased and the difference between the mild TBI group and the control group was not statistically significant.In severe TBI group and moderate TBI group,the activity of DAO,the level of D-LAC and ET at 3,12 hours post-injury were significantly increased than those in the control group and the mild TBI group respectively(P<0.01).At 72 hours post-injury,they were all significantly higher than those in the control group and the mild TBI group respectively(P<0.01).Conclusion Varying degrees of damages of intestinal mucosal barrier dysfunction occur after varying degrees of TBI.The mild TBI shows transient damage of intestinal mucosal barrier dysfunction which occurs at 24 hours post-injury and recovers normal at 72 hours post-injury.The moderate and severe TBI shows damage of intestinal mucosal barrier dysfunction which occurs earlier than mild TBI and lasts for more than 72 hours post-injury.