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烧伤程度显著影响烧伤患者住院第 1 天的血清微量元素和宏量元素浓度。

The Extent of Burn Injury Significantly Affects Serum Micro- and Macroelement Concentrations in Patients on the First Day of Hospitalisation.

机构信息

Department of Medical Chemistry, Pomeranian Medical University, Powstańców Wlkp. 71 Street, 70-111 Szczecin, Poland.

West Pomeranian Center of Treating Severe Burns and Plastic Surgery, Niechorska 27 Street, 72-300 Gryfice, Poland.

出版信息

Nutrients. 2022 Oct 12;14(20):4248. doi: 10.3390/nu14204248.

Abstract

Burns exceeding 30% of total body surface area (TBSA) result in considerable hypovolemia coupled with the formation and release of inflammatory mediators, leading to subsequent systemic effects known as burn shock. Because of plasma exudation and the associated losses of large quantities of minerals, severe burns can lead to nutritional deficiencies and consequently disrupt homeostasis and metabolism of the entire body. The study group comprised 62 patients, who were divided into 3 groups according to the severity of burns. Serum samples were tested for concentrations of Ca, Mg, Mn, P, K, Zn, Cu, Fe, Se, Na, Cr, Ni, and Al. The mineral concentrations in serum of patients with burn injuries differ significantly from reference values, but this is not affected by the extent of the body burn. There are statistically significant decreases in serum concentrations of elements important for antioxidant protection (Zn, Cu, Se), and significant increases in the concentrations of toxic elements (Al and Ni), which may aggravate the effects associated with the state of burn shock. The Spearman rank correlation analysis did not reveal any statistically significant relationships between the serum concentrations of Mn, Ni, Al, K, Na, P, Mg, Zn, Se, Cr and the affected body surface area and severity of the burn-the values were at the lower end of the reference range. The obtained results indicate that proper nutrition, including elements replenishment, is extremely important in the recovery process of burn patients and time to nutrition is an important factor affecting patient survival after severe burn.

摘要

烧伤面积超过总体表面积(TBSA)的 30%会导致大量的低血容量,并伴有炎症介质的形成和释放,从而导致随后的全身性效应,即烧伤休克。由于血浆渗出和大量矿物质的损失,严重烧伤会导致营养不足,从而破坏整个身体的内环境稳定和新陈代谢。研究组包括 62 名患者,根据烧伤的严重程度将他们分为 3 组。检测血清样本中 Ca、Mg、Mn、P、K、Zn、Cu、Fe、Se、Na、Cr、Ni 和 Al 的浓度。烧伤患者血清中的矿物质浓度与参考值有显著差异,但这不受体表面积烧伤程度的影响。抗氧化保护元素(Zn、Cu、Se)的血清浓度显著降低,有毒元素(Al 和 Ni)的浓度显著升高,这可能会加重与烧伤休克状态相关的影响。Spearman 等级相关分析显示,Mn、Ni、Al、K、Na、P、Mg、Zn、Se、Cr 的血清浓度与受影响的体表面积和烧伤严重程度之间没有任何统计学上的显著关系-这些值处于参考范围的较低端。所得结果表明,适当的营养,包括元素补充,对烧伤患者的康复过程极为重要,而营养时间是影响严重烧伤患者生存的重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31e9/9610650/5a801a087998/nutrients-14-04248-g001.jpg

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