Babineau T J, Marcello P, Swails W, Kenler A, Bistrian B, Forse R A
Department of Surgery, Deaconess Hospital, Harvard Medical School, Boston, Massachusetts.
Ann Surg. 1994 Nov;220(5):601-9. doi: 10.1097/00000658-199411000-00002.
The safety and efficacy of PGG-glucan in surgical patients at high risk for postoperative infection who underwent major thoracic or abdominal surgery were determined.
Recent studies have reported a 25% to 27% infectious complication rate in patients undergoing major surgery with an average cost per infected patient of $12,000. The efficacy of PGG-glucan pretreatment in prevention of sepsis has been demonstrated in rodent models for gram-negative and gram-positive bacterial and yeast infections. In vitro studies have demonstrated enhanced microbial killing by monocytes and neutrophils in healthy volunteers after PGG-glucan administration. Thus, PGG-glucan may play a role in decreasing the infectious complication rate in patients undergoing major surgery.
A double-blind, placebo-controlled randomized study was performed in 34 high-risk patients undergoing major abdominal or thoracic surgery.
There were no adverse drug experiences associated with PGG-glucan infusion. Patients who received PGG-glucan had significantly fewer infectious complications (3.4 infections per infected patient vs. 1.4 infections per infected patient, p = 0.05), decreased intravenous antibiotic requirement (10.3 days vs. 0.4 days, p = 0.04) and shorter intensive care unit length of stay (3.3 days vs. 0.1 days, p = 0.03).
PGG-glucan is safe and appears to be effective in the further reduction of the morbidity and cost of major surgery.
确定PGG-葡聚糖在接受胸腹部大手术且术后感染风险高的外科患者中的安全性和有效性。
近期研究报告称，接受大手术的患者感染并发症发生率为25%至27%，每名感染患者的平均费用为12,000美元。在革兰氏阴性菌、革兰氏阳性菌和酵母菌感染的啮齿动物模型中，已证明PGG-葡聚糖预处理对预防败血症有效。体外研究表明，给予PGG-葡聚糖后，健康志愿者的单核细胞和中性粒细胞对微生物的杀伤作用增强。因此，PGG-葡聚糖可能在降低大手术患者的感染并发症发生率方面发挥作用。
对34例接受腹部或胸部大手术的高危患者进行了一项双盲、安慰剂对照的随机研究。
PGG-葡聚糖输注未出现药物不良反应。接受PGG-葡聚糖治疗的患者感染并发症明显较少（每名感染患者3.4次感染 vs. 每名感染患者1.4次感染，p = 0.05），静脉使用抗生素的需求减少（10.3天 vs. 0.4天，p = 0.04），重症监护病房住院时间缩短（3.3天 vs. 0.1天，p = 0.03）。
PGG-葡聚糖是安全的，似乎能有效进一步降低大手术的发病率和成本。
