Effects of Arginine-supplemented Enteral Nutrition on the Prognosis and Immune Function of Trauma Patients ：a Meta-analysis / 中国药房

ABSTRACT

OBJECTIVE： To systematically review the effects of arginine-supplemented enteral nutrition on the prognosis and immune function of trauma patients. METHODS： Retrieved from PubMed， the Cochrane library， Embase， CNKI， Wanfang database， CBM and Chinese Clinical Trial Registry， randomized controlled trials （RCT） about arginine-supplemented enteral nutrition （trial group） versus standard enteral nutrition or other enteral nutrition without arginine （control group） for trauma patients were collected. After literature screening， data extraction and quality evaluation with bias risk evaluation tool of Cochrane System Evaluator Manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS： Totally 13 RCTs were included， involving 777 patients. Results of Meta-analysis showed that fatality rate [RR＝1.67，95％CI（1.07，2.61），P＝0.03]， IgG [MD＝2.81， 95％CI（0.43， 5.18）， P＝0.02]， IgM [MD＝0.30， 95％CI（0.07， 0.54）， P＝0.01]， CD4+ [MD＝5.05， 95％CI（2.55，7.56）， P＜0.000 1] and CD4+/CD8+ [MD＝0.27，95％CI（0.11，0.44）， P＝0.001] in trial group were significantly higher than control group； the level of serum albumin [MD＝－0.47， 95％CI（－0.75，－0.19）， P＝0.000 9] in trial group was significantly lower than control group. There was no statistical significance in the incidence of infectious complications [RR＝0.77，95％CI（0.51，1.17），P＝0.22]， total hospitalization time [MD＝－2.35，95％CI（－10.72，6.02），P＝0.58]， IgA [MD＝0.38，95％CI（－0.06，0.82），P＝0.09]， CD8+ [MD＝－2.49，95％CI（－6.01，1.03），P＝0.17] or the incidence of ADR between 2 groups. CONCLUSIONS： Arginine-supplemented enteral nutrition can improve the immune function of trauma patients， but increase mortality. It is necessary to be cautious in clinical use.