Pancreatic enzyme replacement therapy can improve infection level nutrition condition and prognosis of patients with sepsis.

IF 3.4 4区医学 Q2 FOOD SCIENCE & TECHNOLOGY

Food & Nutrition Research Pub Date : 2025-07-21 eCollection Date: 2025-01-01 DOI:10.29219/fnr.v69.12746

Li Zhao, Sheng Wang

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引用次数: 0

Abstract

Objective: This study aimed to investigate the effects of pancreatic enzyme replacement therapy (PERT) on infection level, nutrition condition and prognosis of patients with sepsis.

Method: According to the fecal elastase-1 (FE1) level, 68 sepsis patients who were diagnosed with pancreatic exocrine insufficiency (PEI) from 2014.11 to 2015. 12 in our hospital were randomly divided into two groups: regular nutritional support (RNS) group or PERT group. A total of 15 patients were dropout for various reasons.Finally, 25 patients were enrolled in PERT group and 28 in RNS group. APACHEII score, SOFA score, inflammatory biomarkers including C-reaction protein (CRP), white blood cell (WBC), procalcitonin (PCT), nutrition markers including prealbumin (PA), transferrin (TFN), retinol binding protein (RBP), creatinine/height index (CHI) were recorded at the day 1 (D1), day7 (D7) and day14 (D14) since they were admitted in ICU. These data were compared between and within the two groups chronologically. Also, the duration of vasoactive drug using (DVAD), mechanical ventilation (DMV), length of stay in ICU (LOS) and survival rate within 14 days were compared between the two groups.

Results: There were no differences in general information (Age and gender) between PERT and RNS groups. Compared with the RNS group, CRP, WBC and PCT declined significantly at D14 in the PERT group. Especially, CRP declined significantly over time in both groups. In addition, compared with the RNS group, in the PERT group at D14, nutrition markers, including PA, TFN, RBP and CHI increased significantly, APACHEII score and SOFA score decreased significantly. And DVAD, DMV and LOS were significantly shortened in PERT group, but the survival rate within 14 days was not significantly changed.

Conclusion: The PERT can improve infection level, nutrition condition and prognosis of patients with sepsis. And the underlying mechanism may be related to improve pancreatic exocrine insufficiency of these patients.

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胰酶替代治疗可改善脓毒症患者的感染水平、营养状况和预后。

目的：探讨胰酶替代疗法（PERT）对脓毒症患者感染水平、营养状况及预后的影响。方法：对2014年11月至2015年诊断为胰腺外分泌功能不全（PEI）的68例败血症患者进行粪便弹性酶-1 （FE1）测定。12例住院患者随机分为常规营养支持（RNS）组和PERT组。15例患者因各种原因中途退出。最后，PERT组25例，RNS组28例。分别于入ICU后第1天（D1）、第7天（D7）、第14天（D14）记录APACHEII评分、SOFA评分、c反应蛋白（CRP）、白细胞（WBC）、降钙素原（PCT）等炎症标志物、白蛋白前（PA）、转铁蛋白（TFN）、视黄醇结合蛋白（RBP）、肌酐/身高指数（CHI）等营养标志物。这些数据按时间顺序在两组之间和两组内部进行比较。比较两组患者血管活性药物使用时间（DVAD）、机械通气时间（DMV）、ICU住院时间（LOS）及14 d内生存率。结果：PERT组和RNS组在一般信息（年龄和性别）方面无差异。与RNS组比较，PERT组在D14时CRP、WBC和PCT显著下降。特别是，两组CRP随时间显著下降。此外，与RNS组相比，D14时PERT组PA、TFN、RBP、CHI等营养指标显著升高，APACHEII评分和SOFA评分显著降低。PERT组DVAD、DMV、LOS明显缩短，但14天内生存率无明显变化。结论：PERT可改善脓毒症患者的感染水平、营养状况和预后。其潜在机制可能与改善这些患者的胰腺外分泌功能不全有关。

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来源期刊

Food & Nutrition Research FOOD SCIENCE & TECHNOLOGY-NUTRITION & DIETETICS

CiteScore

5.20

自引率

9.10%

发文量

审稿时长

14 weeks

期刊介绍： Food & Nutrition Research is a peer-reviewed journal that presents the latest scientific research in various fields focusing on human nutrition. The journal publishes both quantitative and qualitative research papers. Through an Open Access publishing model, Food & Nutrition Research opens an important forum for researchers from academic and private arenas to exchange the latest results from research on human nutrition in a broad sense, both original papers and reviews, including: * Associations and effects of foods and nutrients on health * Dietary patterns and health * Molecular nutrition * Health claims on foods * Nutrition and cognitive functions * Nutritional effects of food composition and processing * Nutrition in developing countries * Animal and in vitro models with clear relevance for human nutrition * Nutrition and the Environment * Food and Nutrition Education * Nutrition and Economics Research papers on food chemistry (focus on chemical composition and analysis of foods) are generally not considered eligible, unless the results have a clear impact on human nutrition. The journal focuses on the different aspects of nutrition for people involved in nutrition research such as Dentists, Dieticians, Medical doctors, Nutritionists, Teachers, Journalists and Manufacturers in the food and pharmaceutical industries.