- Effects of Individualized Comprehensive Nutritional Support on Inflammatory Markers, serum amylase (AMS), prealbumin (PA), albumin (ALB), calcium ion (Ca2+) in Patients with Severe Pancreatitis
Nutritional Support on Inflammatory Markers, serum amylase (AMS), prealbumin (PA), albumin (ALB), calcium ion (Ca2+)
Abstract
Objective: To study the effectiveness of individualized comprehensive nutritional support on inflammatory markers, serum amylase (AMS), prealbumin (PA), albumin (ALB), calcium ion (Ca2+) in patients with severe acute pancreatitis (SAP). Methods: 102 participants with SAP treated in our hospital were chosen as the study objects. The participants were randomly split into control group and observation group, and both groups were given routine treatment. Observation group received individualized comprehensive nutrition support additionally. The inflammatory indexes, biochemical indexes and symptom improvement time were observed and analyzed on the day of admission, intervention 1d, intervention 3d, intervention 7d and intervention 14d. Results: Among the 102 patients included in this study, 3 cases had sudden exacerbation during the intervention, 1 case had clinical data missing >10%, and 1 case voluntarily withdrew due to personal factors, all of which were eliminated. Finally, the effective data of 97 patients were recovered. There were significant differences in the hypersensitive C-reactive protein (hs-CRP), white blood cell count (WBC), procalcitonin (PCT) and interleukin1β (IL-1β) between the two groups. The inter-group, time and interaction differences of AMS, PA, ALB and Ca2+ levels were significant different. The recovery time of abdominal pain, bowel sound, blood amylase level and urine amylase level in observation group was inferior to control group, and the differences were statistically significant (P<0.05). Conclusion: Individualized comprehensive nutritional support is more conducive to the improvement of inflammatory indexes in SAP patients, and can accelerate the symptom relief and promote the recovery of nutritional status.
References
[2]Lin M, Huang J, Chen WC, et al. The Immunomodulatory Effects and Mechanisms of Tim-3 Action in the Early Stage of Mice with Severe Acute Pancreatitis[J].Iran J Immunol, 2020, 17(1): 52-63.
[3]Kanthasamy K A , Akshintala V S , Singh V K .Nutritional Management of Acute Pancreatitis[J].Gastroenterology Clinics of North America, 2020, 50(1):141-150.
[4]Hui L , Zang K , Wang M ,et al.Comparison of the Preference of Nutritional Support for Patients With Severe Acute Pancreatitis[J].Gastroenterology Nursing, 2019, 42(5):411-416.
[5]Schuetz P, Fehr R, Baechli V, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial[J].Lancet, 2019, 393(10188): 2312-2321.
[6]Holdoway A, Page F, Bauer J, et al. Individualised Nutritional Care for Disease-Related Malnutrition: Improving Outcomes by Focusing on What Matters to Patients[J].Nutrients, 2022,14(17): 3534-3534.
[7]Steinberg DI. In medical inpatients at nutritional risk, individualized nutritional support reduced adverse clinical outcomes[J].Ann Intern Med, 2019, 171(4): JC18-JC18.
[8]Phillips M E , Smith N , Mcpherson S ,et al.Nutritional assessment and management in acute pancreatitis: Ongoing lessons of the NCEPOD report[J].Journal of human nutrition and dietetics, 2022, 35(3):504-511.
[9]Lodewijkx, Piet J.Besselink, Marc G.Witteman, Ben J.Schepers, Nicolien J.Gooszen, Hein G.van Santvoort, Hjalmar C.Bakker, Olaf J.Nutrition in acute pancreatitis: a critical review[J].Expert review of gastroenterology & hepatology, 2016, 10(5):571-580.
[10]Bahtouee M, Eghbali SS, Maleki N, et al. Acute Physiology and Chronic Health Evaluation II score for the assessment of mortality prediction in the intensive care unit: a single-centre study from Iran[J].Nurs Crit Care, 2019, 24(6): 375-380.
[11]Shrestha B, Dunn L. The Declaration of Helsinki on Medical Research involving Human Subjects: A Review of Seventh Revision[J].J Nepal Health Res Counc, 2020, 17(4): 548-552.
[12]Jabłońska B, Mrowiec S. Nutritional Support in Patients with Severe Acute Pancreatitis-Current Standards[J].Nutrients, 2021, 13(5): 1498-1498.
[13]Wang C, Zhang Y, Tan J, et al. Improved Integrated Whole Proteomic and Phosphoproteomic Profiles of Severe Acute Pancreatitis[J].J Proteome Res, 2020, 19(6): 2471-2482.
[14]Gupta V, Krishna P, Kochhar R, et al. Hemorrhage complicating the course of severe acute pancreatitis[J].Ann Hepatobiliary Pancreat Surg, 2020, 24(3): 292-300.
[15]Degrate L, Bernasconi DP, Meroni P, et al. Mild acute biliary pancreatitis: the timing of cholecystectomy should not exceed index admission[J].Minerva Chir, 2017, 72(5): 383-390.
[16]Sun B, Gao Y, Xu J, et al. Role of individually staged nutritional support in the management of severe acute pancreatitis[J].Hepatobiliary Pancreat Dis Int, 2004, 3(3): 458-463.
[17]Chen J, Zou L, Sun W, et al. The effects of nutritional support team intervention on postoperative immune function, nutritional statuses, inflammatory responses, clinical outcomes of elderly patients with gastric cancer[J].BMC Surg, 2022, 22(1): 353-353.
[18]Semenza GL. The hypoxic tumor microenvironment: A driving force for breast cancer progression[J].Biochim Biophys Acta, 2016, 1863(3): 382-391.
[19]Sun K, Park J, Gupta OT, et al. Endotrophin triggers adipose tissue fibrosis and metabolic dysfunction[J].Nat Commun, 2014, 5: 3485-3485.
[20]Spencer M, Unal R, Zhu B, et al. Adipose tissue extracellular matrix and vascular abnormalities in obesity and insulin resistance[J].J Clin Endocrinol Metab, 2011, 96(12): E1990-1998.
[21]García-Rayado G, Cárdenas-Jaén K, de-Madaria E. Towards evidence-based and personalised care of acute pancreatitis[J]. United European Gastroenterology Journal, 2020, 8(4): 403-409.
[22]Li W, Liu J, Zhao S, et al. Safety and efficacy of total parenteral nutrition versus total enteral nutrition for patients with severe acute pancreatitis: a meta-analysis[J]. Journal of International Medical Research, 2018, 46(9): 3948-3958.
[23]Panek J, Kuśnierz-Cabala B, Dolecki M, et al. Serum proinflammatory cytokine levels and white blood cell differential count in patients with different degrees of severity of acute alcoholic pancreatitis[J].Pol Przegl Chir, 2012, 84(5): 230-237.
[24]Jafari T , Feizi A , Askari G ,et al.Parenteral immunonutrition in patients with acute pancreatitis: A systematic review and meta-analysis[J].Clinical Nutrition, 2015, 34(1):35-43.
[25]Qiu Z, Cheng F, Jiang H, et al. Efficacy of Microecopharmaceutics Combined with Early Enteral Nutrition Support in the Treatment of Severe Acute Pancreatitis[J].J Coll Physicians Surg Pak, 2020, 30(1): 96-98.
[26]Zielecki P, Kaniewska M, Furmanek M, et al. Effective treatment of severe acute pancreatitis and COVID-19 pneumonia with tocilizumab[J].Prz Gastroenterol, 2020, 15(3): 267-272.
[27]Li Y , Ye Y , Yang M ,et al.Application of semi-automated ultrasonography on nutritional support for severe acute pancreatitis[J].Computerized Medical Imaging and Graphics, 2018, 67:40-44.
[28]Garg V , Singh T , Nain P S ,et al.NUTRITIONAL SUPPORT IN ACUTE SEVERE PANCREATITIS- NASOJEJUNAL VS. NASOGASTRIC FEED[J].Journal of Evolution of Medical and Dental Sciences, 2018, 7(5):588-591.
[29]Roberts K M, Nahikian-Nelms M, Ukleja A, et al. Nutritional aspects of acute pancreatitis[J]. Gastroenterology Clinics, 2018, 47(1): 77-94.
[30]Lee P J, Papachristou G I. New insights into acute pancreatitis[J]. Nature reviews Gastroenterology & hepatology, 2019, 16(8): 479-496.
Copyright (c) 2024 Wei Meng
This work is licensed under a Creative Commons Attribution 4.0 International License.
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.