Influence of preoperative nutritional state on inflammatory response after surgery.
Influence of preoperative nutritional state on inflammatory response after surgery.
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术前营养状态对术后炎症反应的影响
DOI：
10.1016/s0899-9007(99)00176-8
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发表时间：
1999
期刊：
影响因子：
4.4
通讯作者：
Katsushi Yamada
中科院分区：
文献类型：
--
作者：
Kazuo Nakamura;Yukinori Moriyama;H. Kariyazono;Nobuo Hamada;H. Toyohira;Akira Taira;Katsushi Yamada
为了探讨术前营养状态是否影响术后炎症反应和免疫，我们根据术前快速周转蛋白（RTP）将术后全肠外营养支持的患者分为良好营养状态组（I组）和潜在蛋白质-热量营养不良建议组（II组）。 I 组和 II 组的营养指标在手术后显着下降，并在术后第 7 天（POD-）几乎恢复到术前水平。 II组POD-7营养指标显着低于I组（RTP，P < 0.001；白蛋白，P < 0.05）。术后II组白细胞介素6（IL-6）、C反应蛋白（CRP）和多形核（PMN-）弹性蛋白酶水平高于I组（P < 0.01）。在 I 组和 II 组中，IL-6 和白细胞介素 8 (IL-8) 在 CRP 和 PMN 弹性蛋白酶显着升高之前升高。在第一组中，所有营养指标均与 CRP 和 PMN-弹性蛋白酶呈负相关。此外，在IL-6和CRP之间以及IL-8和PMN-弹性蛋白酶之间观察到正相关。总之，术前营养状态的评估对于术后并发症的预测非常重要。
To investigate whether the preoperative nutritional state influences the postoperative inflammatory reaction and immunity, we grouped patients whose postoperative nutritional support was performed by total parenteral nutrition into the good nutritional state group (group I) and the latent protein-calorie malnutrition suggested group (group II) based on the preoperative rapid turnover protein (RTP). Nutritional markers markedly decreased after surgery and recovered almost to preoperative levels on postoperative day (POD-) 7 in groups I and II. Nutritional markers on POD-7 in group II were significantly lower than those in group I (RTP, P < 0.001; albumin, P < 0.05). After surgery, levels of interleukin-6 (IL-6), C-reactive protein (CRP), and polymorphonuclear (PMN-) elastase were higher in group II than in group I (P < 0.01). In groups I and II, IL-6 and interleukin- 8 (IL-8) rose before the remarkable elevation of CRP and PMN-elastase. In group I, all the nutritional markers showed a negative correlation with CRP and PMN-elastase. Further, a positive correlation was observed between IL-6 and CRP and between IL-8 and PMN-elastase. In conclusion, evaluation of the preoperative nutritional state appears to be very important for the prediction of postoperative complication.