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高剂量的维生素C改善了败血症休克患者的诺亚上腺素水平:一个单中心,前性,随机对照试验
Wenwen Li1, Ranran Zhao2, Shanshan Liu1
1Department of Critical Care Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Medicine
|April 12, 2024
概括
在败血症休克中补充维生素C增加了诺亚上腺素合成指标,并减少了对诺亚上腺素的需求,但没有显著改善患者的生存率或临床结果.
科学领域:
- 关键护理医学 关键护理医学
- 营养生物化学 营养生物化学
- 药理学 药理学是指药理学的学科.
背景情况:
- 维生素C在败血症休克中的作用受到争议.
- 上腺素 (NE) 合成对于治疗败血症冲击至关重要.
研究的目的:
- 为了研究不同维生素C剂量对成人败血症休克患者NE合成的影响.
- 为了比较不同维生素C治疗组和安慰剂之间的临床结果和死亡率.
主要方法:
- 58名败血性休克患者被随机分配到高剂量维生素C (150毫克/公斤/天),低剂量维生素C (50毫克/公斤/天) 或安慰剂组.
- 连续测量了NE合成指标 (DβH,TH,BH4,DA),血NE和维生素C水平.
- 评估了包括APACHE,SOFA,MODS得分,ICU停留,通风持续时间和28天死亡率在内的临床结果.
主要成果:
- 维生素C显著增加了铁氨酸氧酶 (TH),四二烯 (BH4) 和多巴胺β-氧酶 (DβH) 的水平.
- 随着维生素C的摄入,血中诺亚上腺素水平增加,外源性NE剂量减少.
- 没有观察到APACHE,SOFA,MODS分数或机械通风持续时间的显著改善;28天的死亡率显示出非显著的减少趋势.
结论:
- 在败血症休克中,维生素C治疗会提高北上腺素合成中的关键酶,并降低对外源性NE的需求.
- 尽管有生物化学变化,但维生素C并没有显著改善该患者队列的临床结果或降低死亡率.
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