华西医学

华西医学

免疫营养素临床应用的合理选择

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营养不足不仅对人体组织器官功能有损害,还可能对患者围手术期并发症发生率和病死率的增加产生影响。在存在营养风险的患者临床治疗过程中,特殊免疫营养素能够发挥重要作用,能降低机体炎症反应,改善患者不良临床结局。特殊免疫营养素包括了谷氨酰胺、ω-3 多不饱和脂肪酸、精氨酸、核苷酸等。有证据显示在不同疾病和阶段,补充不同种类的免疫营养素对机体代谢和炎性反应都能起到调节作用,影响到临床结局和患者预后。目前,部分临床医务人员对免疫营养素的选择及应用存在不规范化现象,亟待相关理论知识推广。该文通过对免疫营养素临床应用的评述,旨在更好地指导临床营养支持实践工作的开展,促进营养支持的规范化发展,使患者获益。

Malnutrition is associated with many adverse clinical outcomes, including increased deaths and complications in perioperative period. The immunonutrition support plays an important role in the recovery process of patients with nutritional risk. Reasonable support can efficiently improve the condition of these cases and strongly suppress the inflammatory response. The immuno-nutrients include glutamine, ω-3 polyunsaturated fatty acids, arginine, nucleotides and so on. More and more evidences show that different kinds of immuno-nutrients play a regulatory role in metabolism and inflammatory response in patients with different disease stages and courses, and affect clinical outcomes and prognosis. Nowadays, there is an urgent need to standardize immunonutrition support in clinical work. In this paper, the related literatures about immunonutrition in recent years were reviewed. Our goal is to reduce the number of irregularities in the nutrition support practice, and to help nutritional risk patients achieve better clinical outcomes.

关键词: 肠外营养; 肠内营养; 营养不足; 免疫营养; 临床应用

Key words: Parenteral nutrition; Enteral nutrition; Undernutrition; Immunonutrition; Clinical application

引用本文: 陈博, 熊茂明, 孟翔凌. 免疫营养素临床应用的合理选择. 华西医学, 2018, 33(3): 354-358. doi: 10.7507/1002-0179.201611034 复制

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