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颅脑损伤患者的免疫营养与细胞因子反应

Immunonutrition and cytokine response in patients with head injury.

作者信息

Khorana Jiraporn, Rerkasem Kittipan, Apichartpiyakul Chatchawann, Sakonwasun Choompone, Watcharasakslip Wanarak, Waniyapong Tanat, Norasethtada Thanya, Jittawatanarak Kaweesak

机构信息

Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

J Med Assoc Thai. 2009 Feb;92(2):188-94.

Abstract

BACKGROUND

To investigate whether short-term postoperative immunonutrients feeding can modulate the level of cytokines in patients with head injury compared to standard enteral tube feeding formula.

MATERIAL AND METHOD

A randomized double-blind study was carried out on 40 moderate to severe head injury patients. They were randomized to have continuous nasogastric tube feeding within 24 hours after surgery of either the immunonutrient containing enteral formula (group A) or the standard enteral formula (group B). The level of interleukin-6 (IL-6) and 10 (IL-10) were measured on day 1 (before feeding), and subsequently on day 3 and day 5.

RESULTS

Twenty patients were randomly selected in each group, who had similar severity levels of injury. Compared to the level of IL-6 on day 1, the level of IL-6 was markedly reduced on day 3 in group A (p = 0.002), whereas such reduction in group B was not statistically significant.

CONCLUSION

Short term postoperative immunonutrient feeding can reduce cytokine level, indicating that systemic inflammatory response syndrome might be modulated by such feeding.

摘要

背景

为研究与标准肠内管饲配方相比,术后短期给予免疫营养物质喂养能否调节颅脑损伤患者的细胞因子水平。

材料与方法

对40例中重度颅脑损伤患者进行了一项随机双盲研究。他们被随机分为两组,在术后24小时内分别通过鼻胃管持续给予含免疫营养物质的肠内配方(A组)或标准肠内配方(B组)。在第1天(喂养前)、第3天和第5天测量白细胞介素-6(IL-6)和白细胞介素-10(IL-10)的水平。

结果

每组随机选取20例患者,他们的损伤严重程度相似。与第1天的IL-6水平相比,A组第3天的IL-6水平显著降低(p = 0.002),而B组的这种降低无统计学意义。

结论

术后短期给予免疫营养物质喂养可降低细胞因子水平,表明这种喂养可能调节全身炎症反应综合征。

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