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烧伤患儿的硒状况。

The selenium status of pediatric patients with burn injuries.

作者信息

Dylewski Maggie L, Bender Jodi C, Smith Anne M, Prelack Kathy, Lydon Martha, Weber Joan M, Sheridan Robert L

机构信息

Department of Surgery, Shriners Hospitals for Children, Boston, Massachusetts 02114, USA.

出版信息

J Trauma. 2010 Sep;69(3):584-8; discussion 588. doi: 10.1097/TA.0b013e3181e74c54.

Abstract

BACKGROUND

Dietary selenium (Se) requirements during critical illness are not well known. The objective of this study was to assess the longitudinal Se status of pediatric patients with burns.

METHODS

Twenty patients admitted to our hospital with burns exceeding 10% of their total body surface area were studied longitudinally during the first 8 weeks of admission or until 95% wound closure was achieved. Dietary Se intake was calculated daily, and plasma and urine samples were collected weekly for analyses of plasma Se, urinary Se, and glutathione peroxidase activity.

RESULTS

Patients included in this study were individuals with an average age of 6.5 years ± 5.3 years and with burn injury of a mean total body surface area of 42% ± 21%. Dietary Se intake throughout the study (mean = 60 μg/d ± 39 μg/d) was consistent with established standards for healthy children and did not change throughout the study. Plasma Se (mean = 1.08 μmol/L ± 0.34 μmol/L) and plasma glutathione peroxidase (mean = 3.2 U/g protein ± 1.42 U/g protein) were below reported normal values for healthy American children. Mean urinary Se excretion (65.9 μg/L ± 50 μg/L) exceed dietary Se intake. Plasma Se was inversely related to incidence of total infection (p = 0.04).

CONCLUSIONS

Results from this study indicate that Se status is depressed among pediatric patients with burns and that recommended Se intake for healthy children is likely insufficient for this population. Further studies are necessary to elucidate the amount of dietary Se required to maximize Se stores among pediatric patients with burn injuries.

摘要

背景

危重病期间的膳食硒(Se)需求量尚不明确。本研究的目的是评估烧伤患儿的硒状态变化情况。

方法

对我院收治的20例烧伤面积超过体表面积10%的患儿进行纵向研究,观察期为入院后的前8周或直至伤口愈合率达到95%。每日计算膳食硒摄入量,每周采集血浆和尿液样本,分析血浆硒、尿硒和谷胱甘肽过氧化物酶活性。

结果

本研究纳入的患儿平均年龄为6.5岁±5.3岁,平均烧伤总面积为42%±21%。整个研究期间的膳食硒摄入量(平均=60μg/d±39μg/d)符合健康儿童的既定标准,且在研究过程中没有变化。血浆硒(平均=1.08μmol/L±0.34μmol/L)和血浆谷胱甘肽过氧化物酶(平均=3.2U/g蛋白±1.42U/g蛋白)低于美国健康儿童报告的正常值。平均尿硒排泄量(65.9μg/L±50μg/L)超过膳食硒摄入量。血浆硒与总感染发生率呈负相关(p=0.04)。

结论

本研究结果表明,烧伤患儿的硒状态较低,健康儿童推荐的硒摄入量可能不足以满足该人群的需求。有必要进一步研究以阐明烧伤患儿最大化硒储备所需的膳食硒量。

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