The beneficial effects of antioxidant supplementation in enteral feeding in critically ill patients: A prospective, randomized, double-blind, placebo-controlled trial
The beneficial effects of antioxidant supplementation in enteral feeding in critically ill patients: A prospective, randomized, double-blind, placebo-controlled trial
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DOI：
10.1213/01.ane.0000133144.60584.f6
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发表时间：
2004-09-01
影响因子：
5.7
通讯作者：
Napoli, C
中科院分区：
文献类型：
--
作者：
Crimi, E;Liguori, A;Napoli, C
我们研究了在肠内喂养中使用抗氧化剂维生素C和E干预是否会影响危重患者的氧化应激和临床结局。预计需要至少10天肠内喂养的216例患者完成了研究。105名患者接受了补充抗氧化剂的肠道喂养，111名对照患者接受了等热量配方。在基线和10天结束时测定血浆脂质过氧化（通过硫代巴比妥酸反应物质[TBARS]和前列腺素F-2 α异前列腺素水平）、低密度脂蛋白（LDL）氧化能力和LDL生育酚含量。还评估了临床28天结局。治疗前血浆TBARS和异前列腺素分别为5.33 +/- 1.26 nM/mL和312 68 pg/mL，干预后分别为2.42 +/- 0.61 nM/mL和198 +/- 42 pg/mL（两项比较P < 0.01）。抗氧化剂使LDL对氧化应激的抵抗力提高了约30%（治疗前的滞后时间为87 +/- 23 min，治疗后为118 +/- 20 min; P < 0.04）。抗氧化剂干预后28天死亡率显著降低（抗氧化剂组为45.7%，常规喂养组为67.5%; P < 0.05）。在涉及抗氧化剂的研究中，异前列烷可为剂量选择提供敏感的生化标志物。
We investigated whether intervention with antioxidant vitamins C and E in enteral feeding influenced oxidative stress and clinical outcome in critically ill patients. Two-hundred-sixteen patients expected to require at least 10 days of enteral feeding completed the study. One-hundred-five patients received enteral feeding supplemented with antioxidants, and 111 control patients received an isocaloric formula. Plasma lipoperoxidation (by thiobarbituric acid reactive substances [TBARS] and prostaglandin F-2alpha isoprostane levels), low-density lipoprotein (LDL) oxidizability, and LDL tocopherol content were determined at baseline and at the end of the 10-day period. The clinical 28-day outcome was also assessed. Plasma TBARS and isoprostanes were 5.33 +/- 1.26 nM/mL and 312 68 pg/mL, respectively, before treatment and 2.42 +/- 0.61 nM/mL and 198 +/- 42 pg/mL after intervention (P < 0.01 for both comparisons). Antioxidants improved LDL resistance to oxidative stress by approximately 30% (the lag time before treatment was 87 +/- 23 min and was 118 +/- 20 min after treatment; P < 0.04). There was a significantly reduced 28-day mortality after antioxidant intervention (45.7% in the antioxidant group and 67.5% in the regular-feeding group; P < 0.05). Isoprostanes may provide a sensitive biochemical marker for dose selection in studies involving antioxidants.