|
|
 |
 |
微量营养素与人体免疫功能的研究进展 |
 |
| |
一直以来，微量营养素各自特有的生理功能得到广泛关注，而对其刺激免疫细胞和调节细胞因子等免疫调节作用的关注较少。本文对微量营养素与免疫功能的关系的研究进展进行综述。 |
|
|
|
不同时间开始的肠外营养与肠内营养对急性胰腺炎影响的对比 |
|
| |
目的 探讨并对比不同时间开始的肠外营养与肠内营养对急性胰腺炎的影响。方法 在MEDLINE、EMBASE、Cochrane图书馆、万方期刊库和中国期刊网检索1966年1月至2011年1月发表的有关全胃肠外营养和肠内营养治疗急性胰腺炎的随机对照研究。由2名评价者对入选研究的研究设计、研究对象的特征、研究结果等内容独立进行摘录，采用RevMan 4.2软件进行分析。结果 有14项研究纳入本研究。本研究结果显示，入院24h后，与全胃肠外营养相比，肠内营养能显著降低感染(P=0.0004)、手术(P=0.0200)、器官衰竭(P=0.0400)及死亡率(P=0.0002)；入院48h内，与全胃肠外营养相比，肠内营养能显著降低感染(P=0.0000)、手术(P=0.0001)、器官衰竭(P=0.0006)及死亡率(P=0.0300)。结论 肠内营养的疗效可能受营养开始时间的限制，急性胰腺炎患者入院24~48h开始肠内营养优于入院24h内或48h后开始。 |
|
|
|
Nutritional risk screening (NRS 2002): a new methodb ased on an analysis of controlledc linical trials(2003) |
|
| |
Background & Aims: A system for screening of nutritional risk is described. It is based on the concept that nutritional support is indicated in patients who are severely ill with increased nutritional requirements, or who are severely undernourished, orwho have certain degrees of severity of disease in combinationwith certain degrees of undernutrition. Degrees of severity of disease and undernutritionwere de¢ned as absent, mild, moderate or severe from data sets in a selectednumber of randomizedc ontrolledtr ials (RCTs) andconvertedto a numeric score. After completion, the screening systemwas validated against all published RCTs known to us of nutritional support vs spontaneous intake to investigate whether the screening system coulddistinguish between trials with a positive outcome andtr ials with no e¡ect on outcome.
Methods: The total number of randomized trials identi¢ed was128. In each trial, the group of patients was classi¢ed with respect to nutritional status andse verity of disease, andit was determined whether the e¡ect of nutritional intervention on clinical outcomewas positive or absent.
Results: Among 75 studies of patients classi¢edas beingnutritionally at-risk,43 showeda positive e¡ectof nutritional support on clinical outcome. Among 53 studies of patients not considered to be nutritionally at-risk,14 showed a positive e¡ect (P=0.0006).This corresponded to a likelihood ratio (true positive/false positive) of 1.7 (95% CI: 2.3^1.2). For 71studies of parenteral nutrition, the likelihood ratio was 1.4 (1.9^1.0), and for 56 studies of enteral or oral nutrition the likelihoodr atiowas 2.9 (5.9^1.4).
Conclusion: The screening systemappears to be able to distinguish between trials with a positive e¡ect vs no e¡ect, andi t can therefore probably also identify patientswho are likely to bene¢t fromnutritional support. |
|
|
|
