Use of some pre-, pro- and synbiotics in critically ill patients
Use of some pre-, pro- and synbiotics in critically ill patients
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DOI：
10.1016/s1521-6918(03)00073-8
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发表时间：
2003-10-01
影响因子：
3.2
通讯作者：
Bengmark, S
中科院分区：
文献类型：
--
作者：
Bengmark, S
维持肠道环境是决定危重病人和术后病人护理结果的关键因素。保持充满抗感染和抗炎化合物的胃肠道分泌物和肠道菌群尤为重要。益生元，通常是多糖，具有很强的生物活性，摄入益生元已被证明可以降低感染率，恢复病人和术后患者的健康。益生菌可能至少有五种功能，对病人都很重要：减少或消除各种潜在的致病微生物；减少或消除各种毒素、诱变剂、致癌物等；先天和适应性免疫防御机制的调节促进细胞凋亡；并释放众多营养、抗氧化、生长、凝血等恢复所必需的因子。预益生菌和益生菌的组合被称为“合成益生菌”。我们在重症患者的合成治疗方面的经验有限，但在重症急性胰腺炎、慢性肝炎和肝移植的研究中取得的最新成果为未来带来了巨大的希望。这一点尤其重要，因为包括使用抗生素在内的药物治疗在很大程度上已经失败，而医学界非常需要新的治疗范例。
Maintenance of the gut environment is a key factor in determining outcome in the care of critically ill and postoperative patients. It is especially important to maintain both gastrointestinal secretions, full of anti-infectious and anti-inflammatory compounds, and the gut flora. Prebiotics, usually polysaccharides, exhibit strong bio-activity and the ingestion of prebiotics has been shown to reduce the rate of infection and restore health in sick and postoperative patients. Probiotics may have at least five functions, all of great importance to the sick patients: the reduction or elimination of potentially pathogenic micro-organisms of various kinds; the reduction or elimination of various toxins, mutagens, carcinogens, etc.; modulation of the innate and adaptive immune defence mechanisms; the promotion of apoptosis; and the release of numerous nutrient, antioxidant, growth, coagulation and other factors necessary for recovery. A combination of pre-and probiotics is referred to as 'synbiotics'. Our experience of synbiotic treatment in critically ill patients is limited, but cutting-edge results from studies of severe acute pancreatitis, chronic hepatitis and liver transplantation offer great hope for the future. This is especially important as pharmaceutical treatment, including the use of antibiotics, has largely failed, and the medical world is in much need of new treatment paradigms.