不同肠内营养输注速率递增策略对危重症患者再喂养综合征影响及代谢机制研究

注册号:

Registration number:

ChiCTR2500114224 

最近更新日期:

Date of Last Refreshed on:

2025-12-09 14:25:11 

注册时间:

Date of Registration:

2025-12-09 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

不同肠内营养输注速率递增策略对危重症患者再喂养综合征影响及代谢机制研究

Public title:

The Impact of Different Enteral Nutrition Infusion Rate Escalation Strategies on Refeeding Syndrome in Critically Ill Patients and the Underlying Metabolic Mechanisms

注册题目简写:

English Acronym:

研究课题的正式科学名称:

不同肠内营养输注速率递增策略对危重症患者再喂养综合征影响及代谢机制研究

Scientific title:

The Impact of Different Enteral Nutrition Infusion Rate Escalation Strategies on Refeeding Syndrome in Critically Ill Patients and the Underlying Metabolic Mechanisms

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

王楚军 

研究负责人:

王楚军 

Applicant:

Wang Chujun 

Study leader:

Wang Chujun 

申请注册联系人电话:

Applicant telephone:

+86 183 3479 6305

研究负责人电话:

Study leader's
telephone:

+86 183 3479 6305

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

1135622462@qq.com

研究负责人电子邮件:

Study leader's E-mail:

1135622462@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

山西省太原市杏花岭区五一路382号

研究负责人通讯地址:

山西省太原市杏花岭区五一路382号

Applicant address:

No. 382 Wuyi Road, Xinghualing District, Taiyuan City, Shanxi Province, China

Study leader's address:

No. 382 Wuyi Road, Xinghualing District, Taiyuan City, Shanxi Province, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

山西医科大学第二医院

Applicant's institution:

Second Hospital of Shanxi Medical University

研究负责人所在单位:

山西医科大学第二医院

Affiliation of the Leader:

Second Hospital of Shanxi Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

[2025]YX第349号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

山西医科大学第二医院

Name of the ethic committee:

Second Hospital of Shanxi Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-10-20 00:00:00

伦理委员会联系人:

牛金亮

Contact Name of the ethic committee:

Niu Jinliang

伦理委员会联系地址:

山西省太原市杏花岭区五一路382号

Contact Address of the ethic committee:

No. 382 Wuyi Road, Xinghualing District, Taiyuan City, Shanxi Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 159 3410 9777

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

山西医科大学第二医院

Primary sponsor:

Second Hospital of Shanxi Medical University

研究实施负责(组长)单位地址:

山西省太原市杏花岭区五一路382号

Primary sponsor's address:

No. 382 Wuyi Road, Xinghualing District, Taiyuan City, Shanxi Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

山西省

市(区县):

太原市

Country:

China

Province:

Shanxi

City:

Taiyuan

单位(医院):

山西医科大学第二医院

具体地址:

山西省太原市杏花岭区五一路382号

Institution
hospital:

Second Hospital of Shanxi Medical University

Address:

No. 382 Wuyi Road, Xinghualing District, Taiyuan City, Shanxi Province, China

经费或物资来源:

自筹

Source(s) of funding:

self-raised funds

研究疾病:

再喂养综合征  

Target disease:

Refeeding Syndrome,RFS

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

1.首要目标:明确不同EN输注速率递增策略对危重症患者RFS发生率的影响; 2.次要目标:评估不同EN输注速率递增策略对能量与蛋白达标率、胃肠道不耐受发生率的影响; 3.附加目标:探讨不同EN输注速率递增策略对危重症患者血液中C肽水平、电解质(血磷、钾、镁)、维生素B1、血糖值的影响,从而分析RFS的代谢机制;  

Objectives of Study:

1. Primary Objective: To determine the impact of varying enteral nutrition infusion rate escalation strategies on the incidence of refeeding syndrome in critically ill patients; 2. Secondary Objective: To evaluate the effects of different enteral nutrition infusion rate escalation strategies on target achievement rates for energy and protein intake, as well as the incidence of gastrointestinal intolerance; 3. Additional Objective: To investigate the influence of varying enteral nutrition infusion rate escalation strategies on plasma C-peptide levels, electrolyte profiles (phosphorus, potassium, magnesium), vitamin B1 concentrations, and blood glucose values in critically ill patients, thereby analyzing the metabolic mechanisms underlying refeeding syndrome.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.终末期恶性疾病; 2.极高RFS风险(BMI<14/禁食>15天/体质量下降>20%); 3.其他低磷因素(透析/甲旁腺手术/肿瘤溶解/磷酸盐结合剂进行肾脏替代治疗); 4.妊娠/哺乳/重度免疫缺陷; 5.诊断为或既往是RFS患者; 6.糖尿病酮症酸中毒并发症。

Exclusion criteria:

1. End-stage malignant disease; 2. Extremely high risk of refeeding syndrome (BMI <14 / fasting >15 days / >20% body weight loss); 3. Other hypophosphatemia risk factors (dialysis / parathyroid surgery / tumor lysis / phosphate-binding agents for renal replacement therapy); 4. Pregnancy / lactation / severe immunodeficiency; 5. Patients diagnosed with or previously having refeeding syndrome; 6. Diabetic ketoacidosis complications.

研究实施时间:

Study execute time:

From 2025-10-20 00:00:00 To 2026-09-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-12-31 00:00:00 To 2026-06-30 00:00:00

干预措施:

Interventions:

组别:

快速递增组(72 h达标)

样本量:

45

Group:

Fast Group(72 h to Target)

Sample size:

干预措施:

第一天给予50%的目标热量,第二天给予75%的目标热量,第三天及以后给予100%的目标热量;

干预措施代码:

Intervention:

Day 1: Administer 50% of the target caloric intake. Day 2: Administer 75% of the target caloric intake. Day 3 onward: Maintain 100% of the target caloric intake.

Intervention code:

组别:

中速递增组(5 d达标)

样本量:

45

Group:

Medium Group (5 d to Target)

Sample size:

干预措施:

第一天及第二天给予50%的目标热量,第三天和第四天给予患者83%的目标热量,第五天及以后给予100%的目标热量;

干预措施代码:

Intervention:

Fifty percent of the target caloric intake is administered on Day 1 and Day 2, increasing to eighty-three percent on Day 3 and Day 4, with full caloric targets (100%) delivered from Day 5 onwards.

Intervention code:

组别:

慢速递增组(7 d达标)

样本量:

45

Group:

Slow Group(7 d to Target)

Sample size:

干预措施:

前三天每日给予患者50%的目标热量,第四天给予70%的目标热量,第五天给予80%的目标热量 ,第六天给予 90%的目标热量,第七天及及以后每日给予100%的目标热量。

干预措施代码:

Intervention:

During the initial three days, patients are administered 50% of the target caloric requirement daily. On the fourth day, this is increased to 70% of the target caloric intake. The dosage is further escalated to 80% on the fifth day, followed by 90% on the sixth day. From the seventh day onward, patients receive the full 100% of the target caloric requirement daily.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

山西省 

市(区县):

太原市 

Country:

China

Province:

Shanxi

City:

Taiyuan

单位(医院):

山西医科大学第二医院 

单位级别:

三甲 

Institution
hospital:

Second Hospital of Shanxi Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

再喂养综合征发生率

指标类型:

主要指标

Outcome:

The incidence rate of refeeding syndrome

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血磷

指标类型:

次要指标

Outcome:

serium inorganic phosphorus

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

胃肠道不耐受发生率

指标类型:

次要指标

Outcome:

The incidence of gastrointestinal intolerance

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

能量与蛋白达标率

指标类型:

次要指标

Outcome:

Energy and Protein Target Achievement Rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血钾

指标类型:

次要指标

Outcome:

serum potassium

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血镁

指标类型:

次要指标

Outcome:

Blood magnesium

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血糖值

指标类型:

附加指标

Outcome:

blood glucose level

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血清维生素B1浓度

指标类型:

附加指标

Outcome:

Serum vitamin B1 concentration

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

C肽水平

指标类型:

附加指标

Outcome:

C-peptide level

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 100 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

随机序列由独立统计学专家使用 SPSS 26.0 软件生成

Randomization Procedure (please state who generates the random number sequence and by what method):

The random sequence was generated using the SPSS 26.0 software by an independent statistician.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

数据收集人员和结局评估者、统计分析人员

Blinding:

Data collectors, outcome assessors, and statistical analysts

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

EDC

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

EDC

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-12-09 14:24:54