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β-葡聚糖对多发伤患者血清白细胞介素-12、超敏C反应蛋白水平及临床结局的影响:一项前瞻性随机研究。

Effect of ß-glucan on serum levels of IL-12, hs-CRP, and clinical outcomes in multiple-trauma patients: a prospective randomized study.

作者信息

Fazilaty Zakyeh, Chenari Hamid, Shariatpanahi Zahra Vahdat

机构信息

National Nutrition and Food Technology Research Institute, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran-Iran.

出版信息

Ulus Travma Acil Cerrahi Derg. 2018 Jul;24(4):287-293. doi: 10.5505/tjtes.2017.34514.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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