Young B, Ott L, Kasarskis E, Rapp R, Moles K, Dempsey R J, Tibbs P A, Kryscio R, McClain C
Department of Surgery, University of Kentucky Medical Center, Lexington, USA.
J Neurotrauma. 1996 Jan;13(1):25-34. doi: 10.1089/neu.1996.13.25.
Sixty-eight patients were entered into a randomized, prospective, double-blinded controlled trial of supplemental zinc versus standard zinc therapy to study the effects of zinc supplementation on neurologic recovery and nutritional/metabolic status after severe closed head injury. One month after injury, the mortality rates in the standard zinc group and the zinc-supplemented group were 26 and 12%, respectively. Glasgow Coma Scale (GCS) scores of the zinc-supplemented group exceeded the adjusted mean GCS score of the standard group at day 28 (p = 0.03). Mean motor GCS score levels of the zinc-supplemented group were significantly higher on days 15 and 21 than those of the control group (p = 0.005, p = 0.02). This trend continued on day 28 of the study (p = 0.09). The groups did not differ in serum zinc concentration, weight, energy expenditure, or total urinary nitrogen excretion after hospital admission. Mean 24-h urine zinc levels were significantly higher in the zinc-supplemented group at days 2 (p = 0.0001) and 10 (p = 0.01) after injury. Mean serum prealbumin concentrations were significantly higher in the zinc-supplemented group (p = 0.003) at 3 weeks after injury. A similar pattern was found for mean serum retinol binding protein level (p = 0.01). A significantly larger number of patients in the standard zinc group had craniotomies for evacuation of hematoma; thus a bias may have been present. The results of this study indicate that zinc supplementation during the immediate postinjury period is associated with improved rate of neurologic recovery and visceral protein concentrations for patients with severe closed head injury.
68例患者进入一项随机、前瞻性、双盲对照试验，比较补充锌与标准锌疗法，以研究补充锌对重度闭合性颅脑损伤后神经功能恢复及营养/代谢状况的影响。受伤后1个月，标准锌组和补充锌组的死亡率分别为26%和12%。补充锌组在第28天的格拉斯哥昏迷量表（GCS）评分超过标准组的校正平均GCS评分（p = 0.03）。补充锌组在第15天和第21天的平均运动GCS评分水平显著高于对照组（p = 0.005，p = 0.02）。这一趋势在研究的第28天仍持续存在（p = 0.09）。入院后，两组在血清锌浓度、体重、能量消耗或尿总氮排泄方面无差异。补充锌组在受伤后第2天（p = 0.0001）和第10天（p = 0.01）的平均24小时尿锌水平显著更高。受伤后3周，补充锌组的平均血清前白蛋白浓度显著更高（p = 0.003）。血清视黄醇结合蛋白平均水平也发现了类似模式（p = 0.01）。标准锌组有更多患者因血肿清除而行开颅手术；因此可能存在偏差。本研究结果表明，重度闭合性颅脑损伤患者在伤后即刻补充锌与神经功能恢复率提高及内脏蛋白浓度升高有关。
