Effect of selenium supplementation on biochemical markers and outcome in critically ill patients
Effect of selenium supplementation on biochemical markers and outcome in critically ill patients
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DOI：
10.1016/j.clnu.2006.10.003
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发表时间：
2007-02-01
影响因子：
6.3
通讯作者：
Shenkin, Alan
中科院分区：
文献类型：
--
作者：
Mishra, Vinita;Baines, Malcolm;Shenkin, Alan
背景和目标：本研究旨在评估高剂量硒（Se）补充对重症监护病房（ICU）严重脓毒症患者血硒状态、氧化应激、甲状腺功能的影响以及对肾脏替代治疗（RRT）需求的可能影响。方法：这项前瞻性单中心研究在40名脓毒症ICU患者中进行，这些患者被随机分配到高剂量硒组，（Se+组，N = 18（474，316，158 μ g/天），每个连续3天，随后给予标准剂量31.6 μ g/天的Se（以亚硒酸钠形式给予），而对照组（Se-，N = 22）仅接受标准剂量的Se。血浆硒、谷胱甘肽过氧化物酶（GSH-Px）、F2异前列腺素、甲状腺功能试验分别于第0、3、7、14天检测血清总T4、总T3、C反应蛋白（CRP）、红细胞谷胱甘肽过氧化物酶（GSH-Px）。硒+组与硒-组相比，血浆硒在第3、7天（P < 0.0001）和第14天（P = 0.02）升高，血浆GSH-Px在第3、7天（P = 0.01）升高。入院时血硒水平与脓毒症相关器官衰竭评分（SOFA）呈显著负相关（r =-0.36，P = 0.03），与低血硒、高CRP呈沿着。肾脏替代治疗的要求是没有显着差异groups.Conclusion：虽然高剂量的硒补充增加血浆硒和GSH-Px活性，它并没有减少氧化损伤或RRT的要求。血液中的硒水平受再分布和疾病严重程度的影响，因此应谨慎解释。(c)2006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 Et Aims: This study aimed to assess the effect of high dose selenium (Se) supplementation on Se status in blood, oxidative stress, thyroid function and possible effects on requirement for renal replacement therapy (RRT) in severely septic patients admitted to the intensive care unit (ICU).Methods: This prospective single-centre study was carried out in 40 septic ICU patients who were randomized to high dose Se (Se+ group, N = 18 (474, 316,158 mu g/day), each for 3 consecutive days followed by a standard dose of 31.6 mu g/day of Se given as sodium selenite whereas the control group (Se-, N = 22) received only the standard dose of Se. Plasma Se, glutathione peroxidase (GSH-Px), F2 isoprostanes, thyroid function tests (total T4 and total T3), C-reactive protein (CRP) and red blood cell (RBC) GSH-Px were estimated on day 0, 3, 7, 14.Results: In the Se+ group, plasma Se increased by day 3 and 7 (P < 0.0001) and day 14 (P = 0.02), plasma GSH-Px increased by day 3 and 7 (P = 0.01) as compared to Se- group. There was a significant negative correlation between plasma Se and SOFA (sepsis related organ failure assessment) (r = -0.36, P = 0.03) along with low plasma Se and high CRP at the time of admission. Requirement for renal replacement therapy was not significantly different between the groups.Conclusion: Although high dose Se supplementation increased plasma Se and GSH-Px activity, it did not reduce oxidative damage or the requirement for RRT. Se levels in blood are influenced by redistribution and severity of illness and therefore should be interpreted with caution. (c) 2006 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.