Time to wound closure in trauma patients with disorders in wound healing is shortened by supplements containing antioxidant micronutrients and glutamine: A PRCT
Time to wound closure in trauma patients with disorders in wound healing is shortened by supplements containing antioxidant micronutrients and glutamine: A PRCT
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DOI：
10.1016/j.clnu.2012.01.002
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发表时间：
2012-08-01
影响因子：
6.3
通讯作者：
Ellinger, Sabine
中科院分区：
文献类型：
--
作者：
Blass, Sandra C.;Goost, Hans;Ellinger, Sabine
背景和目标：:我们假设，在创伤患者的伤口愈合障碍的伤口闭合是通过补充抗氧化微量营养素和谷氨酰胺加速。方法：在一项随机、双盲、安慰剂对照试验中，20名创伤患者的伤口愈合障碍口服补充抗氧化微量营养素（抗坏血酸、α-生育酚、β-胡萝卜素、锌、硒）和谷氨酰胺（verum），或者他们接受等能量量的麦芽糊精（安慰剂）14天。在补充之前和之后测定微量营养素、谷氨酰胺和血管内皮生长因子-A（VEGF-A）的血浆/血清水平。在伤口中，测量微循环的几个参数。结果：血浆/血清中的营养素没有变化，除了硒在verum组中增加（1.1 +/- 0.2 vs. 1.4 +/- 0.2 μ mol/l; P = 0.009）。谷氨酰胺仅在安慰剂组中降低（562 +/- 68 vs. 526 +/- 55 μ mol/l; P = 0.047）。维生素缺乏症的患病率和VEGF-A的浓度没有变化。考虑到微循环，安慰剂组仅氧饱和度降低（56.7 +/- 23.4 vs. 44.0 +/- 24.0 [任意单位]; P = 0.043）。Verum组的伤口闭合速度比安慰剂组快（35 +/- 22 vs. 70 +/- 35 d; P = 0.01）。结论：创伤患者伤口愈合障碍时，口服抗氧化剂和谷氨酰胺补充剂可缩短伤口闭合时间。(c)2012年爱思唯尔有限公司和欧洲临床营养与代谢学会。All rights reserved.
Background & aims: : We hypothesize that wound closure in trauma patients with disorders in wound healing is accelerated by supplementation of antioxidant micronutrients and glutamine.Methods: In a randomized, double-blind, placebo-controlled trial, 20 trauma patients with disorders in wound healing were orally supplemented with antioxidant micronutrients (ascorbic acid, alpha-tocopherol, beta-carotene, zinc, selenium) and glutamine (verum) or they received isoenergetic amounts of maltodextrine (placebo) for 14 days. Plasma/serum levels of micronutrients, glutamine, and vascular endothelial growth factor-A (VEGF-A) were determined before and after supplementation. In the wound, several parameters of microcirculation were measured. Time from study entry to wound closure was recorded.Results: Micronutrients in plasma/serum did not change except for selenium which increased in the verum group (1.1 +/- 0.2 vs. 1.4 +/- 0.2 mu mol/l; P = 0.009). Glutamine decreased only in the placebo group (562 +/- 68 vs. 526 +/- 55 mu mol/l; P = 0.047). The prevalence of hypovitaminoses and the concentration of VEGF-A did not change. Considering microcirculation, only O-2-saturation decreased in the placebo group (56.7 +/- 23.4 vs. 44.0 +/- 24.0 [arbitrary units]; P = 0.043). Wound closure occurred more rapidly in the verum than in the placebo group (35 +/- 22 vs. 70 +/- 35 d; P = 0.01).Conclusions: Time to wound closure can be shortened by oral antioxidant and glutamine containing supplements in trauma patients with disorders in wound healing. (c) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.