微量元素与危重病关系研究进展

Trace Elements Supplementation in Critically Ill Patients

微量元素是危重病患者营养支持的重要组成部分,它们不仅是重要的代谢介质,而且广泛参与细胞免疫、伤口愈合和抗氧化反应的各个环节。在危重病的应激状态下,锌、铜、铁和硒等元素可出现缺乏或功能性缺乏,目前大多数研究显示,在标准营养支持外,需额外补充锌和硒,烧伤患者还需适当补铜,除贫血外不支持常规补铁。

Trace elements are essential components of nutrition support of the critically ill patients. They are important not only as intermediaries in metabolism but also for their potential roles in cellular immunity, wound healing, and antioxidant activity. The deficiency of zinc, copper, iron, and selenium occurs under stress situation because of increased losses and decreased levels of the serum-binding proteins during critical illness. In view of high losses, supplementation of zinc and selenium besides standard nutrition therapy appears necessary. Particularly, burn patients needs appropriate supplementation of copper except for standard nutrition therapy. No evidence of excess iron supplementation seems beneficial to the patients except for anemia.