Nguyen P, Schlögl H, Selig L, Baerwald C
Klinik und Poliklinik für Endokrinologie, Nephrologie, Rheumatologie, Bereich Rheumatologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
Klinik und Poliklinik für Endokrinologie, Nephrologie, Rheumatologie, Bereich Endokrinologie und Spezialbereich Ernährungsmedizin, Universitätsklinikum Leipzig, Leipzig, Deutschland.
Z Rheumatol. 2021 Apr;80(3):263-269. doi: 10.1007/s00393-020-00952-7. Epub 2020 Dec 23.
Rheumatic diseases can lead to a state of malnutrition via a variety of mechanisms. Malnutrition is defined as an insufficient availability of energy, proteins, electrolytes and other nutrients compared to the requirements of a healthy body. After such a catabolic phase, a sudden resupply of the body's full caloric needs can cause life-threatening complications due to an acute paucity of electrolytes and micronutrients. Such metabolic disturbances occurring after the reconstitution of nutrition are termed refeeding syndrome. With sufficient background knowledge about the refeeding syndrome, physicians can prevent serious complications for patients through an adequate reconstitution of caloric intake, the monitoring of relevant laboratory parameters and the supplementation of deficient electrolytes and micronutrients. This review aims to explain the pathological mechanisms driving the refeeding syndrome, to identify risk factors for developing a refeeding syndrome especially in patients with rheumatic diseases and to present strategies to prevent the occurrence of the refeeding syndrome during nutrient reconstitution.
风湿性疾病可通过多种机制导致营养不良状态。营养不良的定义是，与健康身体的需求相比，能量、蛋白质、电解质和其他营养素的供应不足。在这样一个分解代谢阶段之后，突然重新供应身体所需的全部热量，可能会因电解质和微量营养素的急性缺乏而导致危及生命的并发症。营养重建后出现的这种代谢紊乱被称为再喂养综合征。有了关于再喂养综合征的足够背景知识，医生可以通过适当重建热量摄入、监测相关实验室参数以及补充缺乏的电解质和微量营养素，来预防患者出现严重并发症。本综述旨在解释导致再喂养综合征的病理机制，识别尤其是风湿性疾病患者发生再喂养综合征的风险因素，并提出在营养重建期间预防再喂养综合征发生的策略。
