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在接受肠外营养的儿科患者中补充硒:是时候采取行动了吗?

Selenium supplementation in pediatric patients using parenteral nutrition: Is it time to do something?

作者信息

Freitas Renata Germano Borges de Oliveira Nascimento, Nogueira Roberto José Negrão, Hessel Gabriel

机构信息

Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2018 Mar;64(3):217-223. doi: 10.1590/1806-9282.64.03.217.

Abstract

OBJECTIVE

To analyze the nutritional status of selenium and verify the effect of its supplementation in pediatric patients during 14 days of parenteral nutrition (PN).

METHOD

This is a series of cases with patients followed for two weeks while using PN. Data collection was performed at the beginning (T0), in the 7th (T1) and 14th days of PN (T2). The supplemented group received 2 µg/kg/day of selenous acid. Weight and height were measured for nutritional status assessment. Tests requested: plasma selenium, albumin, pre-albumin, C-reactive protein (CRP), total cholesterol and HDL-cholesterol.

RESULTS

Fourteen (14) patients with inflammatory process and with low or very low weight for their ages were evaluated. In both groups (with and without supplementation), all patients had low selenium levels. Median plasma selenium concentrations were 17.4 µg/L (T0), 23.0 µg/L (T1) and 20.7 µg/L (T2). Increase and reduction of selenium occurred both in patients with high CRP and in those presenting normalization of this parameter.

CONCLUSION

Lower plasma selenium levels have been detected since the start of the research and supplementation (2 µg/kg/day of selenous acid) was not to enough to approach the reference values.

摘要

目的

分析儿科患者在14天肠外营养(PN)期间的硒营养状况,并验证补充硒的效果。

方法

这是一系列在使用PN期间对患者进行为期两周随访的病例。在PN开始时(T0)、第7天(T1)和第14天(T2)进行数据收集。补充组接受2μg/kg/天的亚硒酸。测量体重和身高以评估营养状况。要求进行的检测包括:血浆硒、白蛋白、前白蛋白、C反应蛋白(CRP)、总胆固醇和高密度脂蛋白胆固醇。

结果

评估了14例患有炎症且年龄别体重低或极低的患者。在两组(补充组和未补充组)中,所有患者的硒水平均较低。血浆硒浓度中位数分别为17.4μg/L(T0)、23.0μg/L(T1)和20.7μg/L(T2)。CRP高的患者和该参数恢复正常的患者中均出现了硒的升高和降低。

结论

自研究开始就检测到较低的血浆硒水平,且补充(2μg/kg/天的亚硒酸)不足以达到参考值。

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