Fazilaty Zakyeh, Chenari Hamid, Shariatpanahi Zahra Vahdat
National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran-Iran.
Ulus Travma Acil Cerrahi Derg. 2018 Jul;24(4):287-293. doi: 10.5505/tjtes.2017.34514.
Trauma is associated with a profound immunological dysfunction. This predisposes patients to infections and adverse outcomes. ß-glucan has been implicated in the initiation of anti-microbial immune response. The present study aimed to evaluate the effects of an enteral diet containing ß-glucan on serum levels of IL-12 and highly-sensitive C-reactive protein (hs-CRP), occurrence of infection, and clinical outcomes in critically ill multiple-trauma patients.
Forty multiple trauma patients requiring enteral nutrition for at least 10 days were randomly assigned to the intervention group (n=20) or the placebo group (n=20). The intervention group received a high-protein enteral diet providing 3 g ß-glucan, and the control group received a similar diet, except for 3 g of maltodextrin as a placebo. Serum levels of IL-12 and hs-CRP were measured on days 0, 10, and 21.
The ß-glucan group showed significantly higher serum levels of IL-12 on day 21 compared to the control group. Infection frequency and duration of mechanical ventilation were significantly lower in the ß-glucan group. A significant difference was found in the Sequential Organ Failure Assessment (SOFA) score in favor of the ß-glucan group. No difference was found in the serum levels of hs-CRP, length of ICU stay, occurrence of infection, and mortality rates between the two groups.
ß-glucan may increase serum levels of IL-12, shorten the duration of mechanical ventilation, and reduce organ failure in critically ill multiple-trauma patients.
创伤与严重的免疫功能障碍相关。这使患者易发生感染及不良后果。β-葡聚糖与抗微生物免疫反应的启动有关。本研究旨在评估含β-葡聚糖的肠内饮食对重症多发伤患者血清白细胞介素-12(IL-12)水平、高敏C反应蛋白(hs-CRP)水平、感染发生率及临床结局的影响。
40例需要肠内营养至少10天的多发伤患者被随机分为干预组(n = 20)和安慰剂组(n = 20)。干预组接受提供3 gβ-葡聚糖的高蛋白肠内饮食,对照组接受类似饮食,但用3 g麦芽糖糊精作为安慰剂。在第0天、第10天和第21天测量血清IL-12和hs-CRP水平。
与对照组相比,β-葡聚糖组在第21天时血清IL-12水平显著更高。β-葡聚糖组的感染频率和机械通气时间显著更低。序贯器官衰竭评估(SOFA)评分存在显著差异,有利于β-葡聚糖组。两组之间在hs-CRP血清水平、重症监护病房(ICU)住院时间、感染发生率及死亡率方面未发现差异。
β-葡聚糖可能会提高重症多发伤患者的血清IL-12水平,缩短机械通气时间,并减少器官衰竭。