摘要
2010 年欧洲肌肉减少症工作组定义了肌肉减少症(sarcopenia),并给出了诊断方法,2016 年肌肉减少症作为 一种疾病纳入 ICD-10 疾病编码中,其关注度逐渐提高。营养治疗是重症医学的重要组成部分,肌肉减少在重症监护病房、 住院患者,特别在老年患者中普遍存在,而提供营养治疗能缩短患者的住院时间、降低患者的死亡率。β-羟基-β-甲基丁酸, 其独特的作用机制 — 增加蛋白合成和减少蛋白分解,使其作为一种临床营养补充剂已经在需要增肌的患者群中安全使用了 数十年,并有大量的研究文献支持。需要增肌的患者群包括增龄性疾病的老人、艾滋病、肿瘤或其他慢性疾病的患者。对 于 ICU 的住院患者来说,肌肉减少症不但意味着衰弱和营养不良,而且增加了患者的死亡风险。因此,预防和减少住院患 者的肌肉减少是ICU 医生应该考虑的治疗因素之一。 而在重症医学领域,对HMB的研究很少。通过综合分析现有的研究, 认为 HMB 是一种值得在 ICU 肌肉减少患者中应用的营养补充剂。
Abstract
In 2010, sarcopenia was defined and its diagnostic methods were provided by European Working Group on Sarcopenia in Older People. In 2016, sarcopenia was included in the new ICD-10-CM code, representing a major step forword in recognizing sarcopenia as a disease, and its attention gradually increased. Nutritional therapy is an important part of critical care medicine. Muscle loss is prevalent in ICU patients, especially in the elderly, and providing nutritional therapy can shorten the hospital stays and reduce the mortality rate. β-hydroxy-β-methylbutyrate possesses a unique mechanism of action - increases protein synthesis and reduces protein breakdown, making it a clinical nutritional supplementation already in the population in need of increasing muscle for many years, and there is a large number of research literature support. The group of people who need to increase muscle mass include older people, AIDS patients, cancer patients, or other patients with chronic diseases. For residents of the ICU, sarcopenia means not only weakness and malnutrition, but also increased the risk of death. Therefore, preventing and reducing muscle loss in hospitalized patients is one of the therapeutic factors that ICU doctors should consider. However, in the field of critical care medicine, little research has been done on HMB. By analyzing existing studies synthetically, it suggests that HMB is considered to be a nutritional supplementation and is worthy of use in ICU patients with muscle loss.
关键词
重症监护病房 /
&beta /
- 羟基 -&beta /
- 甲基丁酸 /
肌肉减少症 /
营养治疗
Key words
Intensive Care Unit /
β-hydroxy-β-methylbutyrate /
Sarcopenia /
Nutritional therapy
王树英,阎渭清.
HMB 对 ICU 肌肉减少患者的作用探讨[J]. 肿瘤代谢与营养电子杂志. 2018, 5(2): 212-215
WANG Shu-ying, YAN Wei-qing.
HMB supplementation on sarcopenia in ICU patients[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2018, 5(2): 212-215
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