Sacks Gordon S, Genton Laurence, Kudsk Kenneth A
Division of Pharmacy Practice, School of Pharmacy, University of Wisconsin-Madison, Wisconsin 53792-7275, USA.
Curr Opin Crit Care. 2003 Aug;9(4):300-5. doi: 10.1097/00075198-200308000-00008.
Specific nutrients such as arginine, glutamine, dietary nucleotides, and omega-3 fatty acids have been shown to influence infectious morbidity, antibiotic use, and hospital length of stay. The combination of these nutrients into one enteral formulation has become known as immune-enhancing diets. Consensus guidelines developed by a number of clinical investigators and published in 2001 concluded that immune-enhancing diets were beneficial in moderate to severely malnourished patients undergoing elective gastrointestinal surgery and patients sustaining severe blunt and penetrating torso trauma. The purpose of this article is to review data published between February 1, 2001, and January 31, 2003, to determine whether new studies substantiated or refuted the current recommendations for the use of immune-enhancing diets in surgical, critically injured, and critically ill patients. Results confirmed the benefits of preoperative administration of immune-enhancing diets in surgical patients but also demonstrated that postoperative administration offered no advantages. Decreased infectious complications were also observed in critically ill patients receiving immune-enhancing diets. Accumulating evidence supports the use of immune-enhancing diets in these specific patient populations.
特定营养素，如精氨酸、谷氨酰胺、膳食核苷酸和ω-3脂肪酸，已被证明会影响感染发病率、抗生素使用及住院时间。将这些营养素组合成一种肠内制剂，就形成了所谓的免疫增强型饮食。一些临床研究人员制定并于2001年发表的共识指南得出结论，免疫增强型饮食对接受择期胃肠手术的中度至重度营养不良患者以及遭受严重钝性和穿透性躯干创伤的患者有益。本文的目的是回顾2001年2月1日至2003年1月31日期间发表的数据，以确定新的研究是否证实或反驳了目前关于在外科手术、严重受伤和重症患者中使用免疫增强型饮食的建议。结果证实了术前给予免疫增强型饮食对手术患者有益，但也表明术后给予并无优势。在接受免疫增强型饮食的重症患者中也观察到感染并发症减少。越来越多的证据支持在这些特定患者群体中使用免疫增强型饮食。
