HMB对ICU肌肉减少患者的作用探讨

HMB supplementation on sarcopenia in ICU patients

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。

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.