Kotler D P, Tierney A R, Culpepper-Morgan J A, Wang J, Pierson R N
Gastrointestinal Division, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York 10025.
JPEN J Parenter Enteral Nutr. 1990 Sep-Oct;14(5):454-8. doi: 10.1177/0148607190014005454.
Malnutrition occurs commonly in patients with acquired immunodeficiency syndrome (AIDS). The efficacy of nutritional support is unknown. A prospective, longitudinal study was conducted to determine the effect of prolonged total parenteral nutrition on body composition in 12 AIDS patients. Five patients were malnourished because of problems with food intake or absorption, while seven had systemic infections, with or without a malabsorption syndrome. The AIDS patients gained body weight and body fat content in response to total parenteral nutrition, while mean body cell mass, estimated as total body potassium content, was unchanged. However, all five patients with altered intake or absorption had significant repletion of body cell mass which was significantly different from the patients with systemic infections. Calorie and nitrogen intake did not differ between the two groups. It is concluded that body mass repletion is possible in AIDS patients in whom malabsorption is the major pathogenetic factor in producing malnutrition and is less successful in patients with serious ongoing systemic diseases. Thus, the response to nutritional support is dependent on the particular clinical circumstances.
营养不良在获得性免疫缺陷综合征（艾滋病）患者中很常见。营养支持的效果尚不清楚。进行了一项前瞻性纵向研究，以确定长期全胃肠外营养对12例艾滋病患者身体组成的影响。5例患者因食物摄入或吸收问题而营养不良，7例患有全身感染，伴有或不伴有吸收不良综合征。艾滋病患者对全胃肠外营养有反应，体重和体脂含量增加，而以全身钾含量估计的平均体细胞量未改变。然而，所有5例摄入或吸收改变的患者体细胞量都有显著补充，这与全身感染患者有显著差异。两组的热量和氮摄入量没有差异。得出的结论是，对于以吸收不良为导致营养不良主要发病因素的艾滋病患者，体重补充是可能的，而对于患有严重持续全身性疾病的患者则不太成功。因此，对营养支持的反应取决于特定的临床情况。
