Effects of fish collagen oligopeptide on operative prognosis of patients with emergency complex hand trauma

doi:10.11958/20231943

Abstract

Abstract:

Objective To observe the effect of enteral nutrition with fish collagen oligopeptide on operative prognosis of patients with emergency complex hand trauma. Methods A total of 122 patients who suffered from complex hand trauma and were operated in the emergency department were retrospectively analyzed. Patients were given early enteral nutritional support after the operation, and were divided into two groups according to different formulations. The control group (60 patients) was given balance nutrients and whey protein, and the experimental group (62 patients) was given fish collagen oligopeptide on the same enteral nutrition formula. Clinical data were compared between the two groups, including hemoglobin (Hb)，lymphocyte count (Lym), neutrophil-lymphocyte ratio (NLR), albumin (ALB), prealbumin (PA), alanine transaminase (ALT), aspartate transaminase (AST), urea nitrogen (BUN), creatinine (Cr), triglyceride (TG), total cholesterol (TC) and low density lipoprotein-C (LDL-C) before and after treatment. The length of hospital stay and the incidence of postoperative infectious complications were compared between the two groups of patients. Results Compared with before treatment, Hb, ALB, liver and kidney function and lipid metabolism indexes of the control group and the experimental group had no significant changes after nutritional treatment, and PA and Lym were significantly increased, and NLR was significantly decreased. After nutritional treatment, compared with the control group, NLR was decreased more significantly in the experimental group (P < 0.01). The incidence of infectious complications was lower in the experimental group than that in the control group, and the length of hospitalization was significantly shortened (P < 0.05). Conclusion Early enteral nutrition supplemented with fish collagen oligopeptide in patients with emergency complex hand trauma can promote prealbumin synthesis, reduce the incidence of inflammation and wound infection, and shorten hospital stay.

Key words: collagenases, prealbumin, nutritional support, prognosis, fish collagen oligopeptide, hand injury

CLC Number:

R151.2

Figures/Tables 3

References 20

[1]	LI X, YANG Y, MA Z F, et al. Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury[J]. Nutr Neurosci, 2022, 25(3):530-536. doi:10.1080/1028415X.2020.1765114.
[2]	GEAHCHAN S, BAHARLOUEI P, RAHMAN A. Marine collagen:a promising biomaterial for wound healing,skin anti-aging,and bone regeneration[J]. Mar Drugs, 2022, 20(1):61. doi:10.3390/md20010061.
[3]	BLACKBUN G L. Metabolic considerations in management of surgical patients[J]. Surg Clin North Am, 2011, 91(3):467-480. doi:10.1016/j.suc.2011.03.001.
[4]	PATEL J J, CODNER P. Controversies in critical care nutrition support[J]. Crit Care Clin, 2016, 32(2):173-189. doi:10.1016/j.ccc.2015.11.002.
[5]	HEYLAND D K, DHALIWAL R, WANG M. The prevalence of iatrogenic underfeeding in the nutritionally ‘at-risk’ critically ill patient:results of an international,multicenter,prospective study[J]. Clin Nutr, 2015, 34(4):659-666. doi:10.1016/j.clnu.2014.07.008.
[6]	DALIRI E, OH D, LEE B. Bioactive peptides[J]. Foods, 2017, 6(5):32-52. doi:10.3390/foods6050032.
[7]	CHAKNIRAMOL S, WIERSCHEM A, CHO M G, et al. Physiological and clinical aspects of bioactive peptides from marine animals[J]. Antioxidants(Basel), 2022, 11(5):1021. doi:10.3390/antiox11051021.
[8]	HWANG S B, PARK H J, LEE B H. Hair-growth-promoting effects of the fish collagen peptide in human dermal papilla cells and C57BL/6 mice modulating Wnt/beta-catenin and BMP signaling pathways[J]. Int J Mol Sci, 2022, 23(19):11904. doi:10.3390/ijms231911904.
[9]	LEE E J, HUR J, HAM S A, et al. Fish collagen peptide inhibits the adipogenic differentiation of preadipocytes and ameliorates obesity in high fat diet-fed mice[J]. Int J Biol Macromol, 2017, 104(Pt A):281-286. doi:10.1016/j.ijbiomac.2017.05.151.
[10]	DE LUCA C, MIKHAL'CHIK E V, SUPRUN M V, et al. Skin antiageing and systemic redox effects of supplementation with marine collagen peptides and plant-derived antioxidants:a single-blind case-control clinical study[J]. Oxid Med Cell Longev, 2016,2016:4389410. doi:10.1155/2016/4389410.
[11]	CHEN J, GAO K, LIU S, et al. Fish collagen surgical compress repairing characteristics on wound healing process in vivo[J]. Mar Drugs, 2019, 17(1):33. doi:10.3390/md17010033.
[12]	苏健光, 马妮娜, 邵春海, 等. 颅脑创伤患者术后肺部感染与营养状况的关系研究[J]. 河南大学学报(医学版), 2020, 39(5):318-321,357.
	SU J G, MA N N, SHAO C H, et al. Correlation between postoperative pulmonary infection and nutritional status in patients with traumatic brain injury[J]. Journal of Henan University(Medical Science), 2020, 39(5):318-321,357. doi:10.15991/j.cnki.41-1361/r.2020.05.004.
[13]	杨栋, 胡雯, 李小丛, 等. 海洋胶原低聚肽对食管癌术后患者血浆蛋白及并发症的影响[J]. 肿瘤代谢与营养电子杂志, 2018, 5(4):376-379.
	YANG D, HU W, LI X C, et al. Effect of marine collagen oligopeptide on plasma protein and complications in postoperative patients with esophageal cancer[J]. Electron J Metab Nutr Cancer, 2018, 5(4):376-379. doi:10.16689/j.cnki.cn11-9349/r.2018.04.009.
[14]	付忠华, 郭光华, 徐成, 等. 肠内免疫营养联合重组人生长激素对严重烧伤病人营养状况和细胞免疫的影响[J]. 南昌大学学报(医学版), 2010, 50(3):49-55.
	FU Z H, GUO G H, XU C, et al. Effects of enteral immune nutrition combined with recombinant human growth hormone on nutritional status and dellular immunity of severely burned patients[J]. Journal of Nanchang University(Medical Science), 2010, 50(3):49-55. doi:10.3969/j.issn.1000-2294.2010.03.014.
[15]	李健, 谢南姿, 王娟, 等. 肠内营养粉安素对老年患者糖、脂代谢及营养状况的影响[J]. 同济大学学报(医学版), 2015, 36(5):93-95.
	LI J, XIE N Z, WANG J, et al. Efficacy of ensure for enteral nutrition in aged patients[J]. Journal of Tongji University(Medical Science), 2015, 36(5):93-95. doi:10.16118/j.1008-0392.2015.05.020.
[16]	DAVIS B K, WEN H, TING J P. The inflammasome NLRs in immunity,inflammation,and associated diseases[J]. Annu Rev Immunol, 2011, 29(1):707-735. doi:10.1146/annurev-immunol-031210-101405.
[17]	潘建虹, 潘笑, 王陈. 严重创伤患者免疫功能动态变化规律及其与创伤感染的关系[J]. 现代实用医学, 2023, 35(9):1220-1224.
	PAN J H, PAN X, WANG C D. Dynamic change of immune function in patients with severe trauma and its relationship with trauma infection[J]. Modern Practical Medicine, 2023, 35(9):1220-1224. doi:10.3969/j.issn.1671-0800.2023.09.032.
[18]	RAVINDRANATHAN D, MASTER V A, BILEN M A. Inflammatory markers in cancer immunotherapy[J]. Biology(Basel), 2021, 10(4):325. doi:10.3390/biology10040325.
[19]	刘志超, 徐可, 布海霞, 等. 预后营养指数联合NLR、PLR在腹膜透析患者全因死亡中的预测价值[J]. 天津医药, 2023, 51(3):290-294.
	LIU Z C, XU K, BU H X, et al. Predictive value of prognostic nutritional index combined with NLR and PLR in all-causemortality of patients with peritoneal dialysis[J]. Tianjin Med J, 2023, 51(3):290-294. doi:10.11958/20221230.
[20]	QIU Y, FITZGERALD M, MITRA B. Association of the neutrophil-lymphocyte ratio to patient outcomes after trauma:a systematic review[J]. Trauma, 2021, 24(3),195-203. doi:10.1177/14604086211034008.

组别	n		年龄/岁		男性		糖尿病	高血压		合并骨折
对照组	60		43.72±12.72		47（78.3）		8（13.3）	18（30.0）		19（31.7）
试验组	62		41.40±11.92		43（69.4）		7（11.3）	22（35.5）		20（32.3）
t或χ²			1.029		1.271		0.118	0.416		0.005
组别		伤口暴露时间/h		创面严重污染		术中出血量/mL			手术时间/h
对照组		3.87±1.51		35（58.3）		100（70，150）			3.64±0.58
试验组		4.11±1.78		40（64.5）		150（50，200）			3.82±0.75
t、χ²或Z		0.817		0.492		0.382			1.492

组别	n		年龄/岁		男性		糖尿病	高血压		合并骨折
对照组	60		43.72±12.72		47（78.3）		8（13.3）	18（30.0）		19（31.7）
试验组	62		41.40±11.92		43（69.4）		7（11.3）	22（35.5）		20（32.3）
t或χ²			1.029		1.271		0.118	0.416		0.005
组别		伤口暴露时间/h		创面严重污染		术中出血量/mL			手术时间/h
对照组		3.87±1.51		35（58.3）		100（70，150）			3.64±0.58
试验组		4.11±1.78		40（64.5）		150（50，200）			3.82±0.75
t、χ²或Z		0.817		0.492		0.382			1.492

组别	n		Hb/（g/L）				Lym/（×10⁹/L）				NLR						ALB/（g/L）
组别	n		治疗前		治疗后	t	治疗前		治疗后	t	治疗前		治疗后			Z	治疗前	治疗后	t
对照组	60		109.66±24.87		108.52±20.22	0.417	1.36±0.52		1.93±0.08	9.866^＊＊	3.40（2.25，4.07）		2.35（1.63，3.04）			6.736^＊＊	31.26±7.12	30.50±6.42	0.565
试验组	62		112.39±17.67		110.56±20.13	0.531	1.45±0.56		2.06±0.41	7.329^＊＊	3.63（3.23，4.29）		1.73（1.45，2.00）			6.741^＊＊	32.92±4.58	31.72±4.06	1.579
t或Z			0.696		0.561		0.903		2.306^＊		1.454		3.907^＊＊				1.528	0.327
组别		PA/（mg/L）							ALT/（U/L）			AST/（U/L）					Cr/（U/L）
组别		治疗前			治疗后	t			治疗前	治疗后	t	治疗前			治疗后	t	治疗前	治疗后	t
对照组		182.41±39.70			223.50±54.42	10.689^＊＊			19.50±8.65	18.72±5.30	0.619	17.30±5.30			15.96±7.91	1.091	60.47±13.18	61.87±11.31	0.833
试验组		187.52±54.61			245.61±45.92	5.950^＊＊			17.21±6.37	17.42±4.53	0.206	15.80±7.54			14.30±6.92	1.064	61.89±10.70	60.81±12.86	0.513
t		0.588			2.361^＊				1.659	1.459		1.276			1.198		0.875	0.483
组别				BUN/（mmol/L）				TC/（mmol/L）				TG/（mmol/L）					LDL-C/（mmol/L）
组别				治疗前	治疗后	t		治疗前		治疗后	t	治疗前		治疗后		t	治疗前	治疗后	t
对照组				6.37±1.19	5.94±1.79	1.402		3.86±0.70		3.69±0.87	1.350	1.27±0.32		1.31±0.65		0.562	2.41±0.62	2.52±0.87	1.282
试验组				6.10±1.42	5.81±1.05	1.207		4.05±0.91		3.85±0.76	1.174	1.34±0.32		1.42±0.61		1.932	2.51±0.81	2.56±0.93	0.332
t				1.150	0.488			1.289		1.083		1.353		0.951			0.764	0.245

组别	n		Hb/（g/L）				Lym/（×10⁹/L）				NLR						ALB/（g/L）
组别	n		治疗前		治疗后	t	治疗前		治疗后	t	治疗前		治疗后			Z	治疗前	治疗后	t
对照组	60		109.66±24.87		108.52±20.22	0.417	1.36±0.52		1.93±0.08	9.866^＊＊	3.40（2.25，4.07）		2.35（1.63，3.04）			6.736^＊＊	31.26±7.12	30.50±6.42	0.565
试验组	62		112.39±17.67		110.56±20.13	0.531	1.45±0.56		2.06±0.41	7.329^＊＊	3.63（3.23，4.29）		1.73（1.45，2.00）			6.741^＊＊	32.92±4.58	31.72±4.06	1.579
t或Z			0.696		0.561		0.903		2.306^＊		1.454		3.907^＊＊				1.528	0.327
组别		PA/（mg/L）							ALT/（U/L）			AST/（U/L）					Cr/（U/L）
组别		治疗前			治疗后	t			治疗前	治疗后	t	治疗前			治疗后	t	治疗前	治疗后	t
对照组		182.41±39.70			223.50±54.42	10.689^＊＊			19.50±8.65	18.72±5.30	0.619	17.30±5.30			15.96±7.91	1.091	60.47±13.18	61.87±11.31	0.833
试验组		187.52±54.61			245.61±45.92	5.950^＊＊			17.21±6.37	17.42±4.53	0.206	15.80±7.54			14.30±6.92	1.064	61.89±10.70	60.81±12.86	0.513
t		0.588			2.361^＊				1.659	1.459		1.276			1.198		0.875	0.483
组别				BUN/（mmol/L）				TC/（mmol/L）				TG/（mmol/L）					LDL-C/（mmol/L）
组别				治疗前	治疗后	t		治疗前		治疗后	t	治疗前		治疗后		t	治疗前	治疗后	t
对照组				6.37±1.19	5.94±1.79	1.402		3.86±0.70		3.69±0.87	1.350	1.27±0.32		1.31±0.65		0.562	2.41±0.62	2.52±0.87	1.282
试验组				6.10±1.42	5.81±1.05	1.207		4.05±0.91		3.85±0.76	1.174	1.34±0.32		1.42±0.61		1.932	2.51±0.81	2.56±0.93	0.332
t				1.150	0.488			1.289		1.083		1.353		0.951			0.764	0.245

组别	n	感染性并发症	术后住院时间/d
对照组	60	10（16.7）	14.50（11.25，17.25）
试验组	62	3（4.8）	11.00（10.00，14.00）
χ²或Z		4.481^＊	3.258^＊