Tuttle-Newhall J E, Veerabagu M P, Mascioli E, Blackburn G L
Nutrition Support Service, New England Deaconess Hospital, Harvard Medical School, Boston, MA 02115.
Nutrition. 1993 May-Jun;9(3):240-4.
Diarrhea, sepsis, and malnutrition in the AIDS population are common. Some authors have predicted length of survival based on malnutrition biomarkers alone (degree of weight loss at presentation and serum albumin). Similarly, the hypothesis that malnutrition creates a vicious cycle that potentiates susceptibility to opportunistic infections may be valid. Consideration should be given to combining aggressive enteral and parenteral support with metabolic support in the acute phase of illness and between bouts of infections to facilitate patient care and to restore lean tissue. A skilled nutritional support service can deliver needed metabolic support along with nutritional support to these patients. In this case, we focused on the challenges of treating a new patient with significant malnutrition associated with AIDS of unknown duration; untreated gastrointestinal pathogens associated with substantial acid-base, electrolyte, and micronutrient deficiency; and systemic sepsis.
艾滋病患者中腹泻、败血症和营养不良很常见。一些作者仅根据营养不良生物标志物（就诊时的体重减轻程度和血清白蛋白）来预测生存时长。同样，营养不良会形成恶性循环，增强对机会性感染易感性的假说可能是成立的。在疾病急性期以及感染发作期间，应考虑将积极的肠内和肠外支持与代谢支持相结合，以方便患者护理并恢复瘦组织。专业的营养支持服务可为这些患者提供所需的代谢支持以及营养支持。在本病例中，我们关注的是治疗一名新患者所面临的挑战，该患者存在与病因不明的艾滋病相关的严重营养不良、与大量酸碱、电解质和微量营养素缺乏相关的未治疗的胃肠道病原体感染，以及全身性败血症。
