Plasma metabolomics of early parenteral nutrition followed with enteral nutrition in pancreatic surgery patients
Plasma metabolomics of early parenteral nutrition followed with enteral nutrition in pancreatic surgery patients
复制标题
胰腺手术患者早期肠外营养随后肠内营养的血浆代谢组学。
DOI：
10.1038/s41598-019-55440-z
复制
发表时间：
2019-12-11
影响因子：
4.6
通讯作者：
Deng, Xiaoming
中科院分区：
文献类型：
--
作者：
Jiang, Zhengyu;Wen, Cen;Deng, Xiaoming
营养支持对于外科病人来说是必不可少的。接受胰腺十二指肠切除术(PD)的患者需要大量的营养支持，但也面临感染和胃肠道并发症的风险。早期肠外营养最近已显示出益处，但有关其对新陈代谢的影响的信息有限。这项前瞻性单中心队列研究使用血浆代谢组学来阐明早期肠外营养和肠内营养后的代谢变化。研究对象为52例接受胰十二指肠切除术的患者。术后3d内肠外营养36例(TPN组)，标准液体16例(GIK组)。我们发现TPN组的体重减轻，而其他临床结局和炎症细胞因子的变化无统计学意义。与GIK组相比，TPN组在氨基酸、脂肪和磷脂代谢方面有显著差异。整合分析表明，早期TPN可促进长链脂肪酸、磷脂、酮体和支链氨基酸的代谢。结论：PD患者早期应用TPN加EN可减少围手术期体重减轻，促进代谢向合成代谢的转变，促进脂代谢的恢复，有利于患者的康复。
Nutrition support is essential for surgical patients. Patients undergoing pancreaticoduodenectomy (PD) require tremendous nutrient support but also faced with risks of infection and gastrointestinal complications. Early parenteral nutrition has recently shown benefits while limited information provided about the influence on metabolism. This prospective single-center cohort study used plasma metabolomics to clarify metabolic alteration after early parenteral nutrition followed with enteral nutrition. Patients undergoing pancreaticoduodenectomy (n = 52) were enrolled. 36 patients received parenteral nutrition within 3 days postoperatively followed with EN (TPN group), 16 patients received standard fluids followed with EN (GIK group). We found that the weight loss is reduced in TPN group while the other clinical outcomes and inflammatory cytokines showed no statistical significance. The TPN group showed significance in amino acids, lipid, and phospholipids metabolism compared with the GIK group. Moreover, integration analysis indicated that early TPN could promote the metabolism of long-chain fatty acids, phospholipids, ketone bodies, and branched-chain amino acids. We conclude that early TPN support followed with EN for patients undergoing PD reduced the perioperative weight loss and promoted the metabolic transition to anabolic metabolism with the recovery of lipid metabolism, suggesting its benefits for the recovery of patients.