补充维生素B6可增强重症患者的免疫反应。

Vitamin B6 supplementation increases immune responses in critically ill patients.

作者信息

Cheng C-H, Chang S-J, Lee B-J, Lin K-L, Huang Y-C

机构信息

Critical Care and Respiratory Therapy, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.

出版信息

Eur J Clin Nutr. 2006 Oct;60(10):1207-13. doi: 10.1038/sj.ejcn.1602439. Epub 2006 May 3.

DOI:10.1038/sj.ejcn.1602439

PMID:16670691

Abstract

OBJECTIVE

To investigate whether vitamin B6 supplementation has a beneficial effect on immune responses in critically ill patients.

DESIGN

A single-blind intervention study.

SETTING

The study was performed at the Taichung Veterans General Hospital, the central part of Taiwan.

SUBJECTS

Fifty-one subjects who stayed over 14 days in the intensive care unit completed the study. Subjects were not treated with any vitamin supplement before the intervention.

INTERVENTIONS

Patients were randomly assigned to one of three groups, control (n = 20), a daily injection of 50 mg vitamin B-6 (B6 -50, n=15), or 100 mg vitamin B-6 (B6 -100, n = 16) for 14 days.

MAIN OUTCOME MEASURES

Plasma pyridoxal 5'-phosphate (PLP), pyridoxal (PL), 4-pyridoxic acid (4-PA), erythrocyte alanine (EALT-AC) and aspartate (EAST-AC) aminotransaminase activity coefficient, and urinary 4-PA were measured. The levels of serum albumin, hemoglobin, hematocrit, high-sensitivity C-reactive protein (hs-CRP) and immune responses (white blood cell, neutrophils, total lymphocytes count (TLC), T- (CD3) and B-(CD19) lymphocytes, T-helper (CD4) and suppressor (CD8) cells) were determined.

RESULTS

Plasma PLP, PL, 4-PA and urinary 4-PA concentrations significantly increased in two treated groups. T-lymphocyte and T-helper cell numbers and the percentage of T-suppressor cell significantly increased on day 14 in the B6 -50 group. Total lymphocyte count, T-helper and T-suppressor cell numbers, the percentage of T-lymphocyte cells and T-suppressors significantly increased in the B6 -100 group at the 14th day. There were no significant changes with respect to immune responses in the control group over 14 days.

CONCLUSIONS

A large dose of vitamin B6 supplementation (50 or 100 mg/day) could compensate for the lack of responsiveness of plasma PLP to vitamin B6 intake, and further increase immune response of critically ill patients.

SPONSORSHIP

This study was supported by the National Science Council, Taiwan, Republic of China (NSC-92-2320-B-040-026).

摘要

目的

探讨补充维生素B6对重症患者免疫反应是否有有益作用。

设计

单盲干预研究。

地点

该研究在台湾中部的台中荣民总医院进行。

研究对象

51名在重症监护病房停留超过14天的患者完成了研究。干预前未接受任何维生素补充剂治疗。

干预措施

患者被随机分为三组之一，对照组（n = 20），每天注射50mg维生素B-6（B6 - 50，n = 15），或100mg维生素B-6（B6 - 100，n = 16），共14天。

主要观察指标

测定血浆磷酸吡哆醛（PLP）、吡哆醛（PL）、4-吡哆酸（4-PA）、红细胞丙氨酸（EALT-AC）和天冬氨酸（EAST-AC）转氨酶活性系数以及尿4-PA。测定血清白蛋白、血红蛋白、血细胞比容、高敏C反应蛋白（hs-CRP）水平及免疫反应指标（白细胞、中性粒细胞、总淋巴细胞计数（TLC）、T细胞（CD3）和B细胞（CD19）、辅助性T细胞（CD4）和抑制性T细胞（CD8））。

结果

两个治疗组的血浆PLP、PL、4-PA和尿4-PA浓度显著升高。B6 - 50组在第14天时T淋巴细胞和辅助性T细胞数量以及抑制性T细胞百分比显著增加。B6 - 100组在第14天时总淋巴细胞计数、辅助性T细胞和抑制性T细胞数量、T淋巴细胞百分比和抑制性T细胞显著增加。对照组在14天内免疫反应无显著变化。