Serum vitamins in adult patients with short bowel syndrome receiving intermittent parenteral nutrition.
Serum vitamins in adult patients with short bowel syndrome receiving intermittent parenteral nutrition.
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DOI：
10.1177/0148607110386964
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发表时间：
2011-07
期刊：
影响因子：
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通讯作者：
C. Braga;H. Vannucchi;C. Freire;J. Marchini;A. Jordão;S. F. da Cunha
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文献类型：
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作者：
C. Braga;H. Vannucchi;C. Freire;J. Marchini;A. Jordão;S. F. da Cunha
背景：短肠综合征（SBS）发生在大量肠切除术后，即使经过一段时间的适应，也可能需要肠外营养（PN）治疗。本研究的目的是确定接受间歇性PN的SBS成人的维生素状态。方法研究对象为接受间歇性PN治疗的住院SBS成人患者（n = 8）。9名健康志愿者，按年龄和性别配对，作为对照。评价食物摄入、人体测量、血浆叶酸和维生素B（12）、C、A、D、E和K。结果两组的维生素A、D和B（12）水平相似。SBS患者的叶酸水平较高（21.3 ± 4.4 vs 14.4 ± 5.2，P = .01）和维生素C值较低（0.9 ± 0.4 vs 1.2 ± 0.3 mg/dL，P = .03），α-生育酚（16.3 ± 3.4 vs 24.1 ± 2.7 µmol/L，P <0.001），叶绿醌（0.6 ± 0.2 vs 1.0 ± 0.5 nmol/L，P <0.03）。87%的患者维生素D缺乏，所有患者的血清维生素E水平均低于参考值。结论：尽管尽一切努力提供上述所有营养素，SBS患者的血清维生素C、E和K水平较低，与家庭PN患者相似。这些结果表明，给予的维生素不足以用于间歇性PN方案，需要根据患者的维生素状态进行个体调整。
BACKGROUND Short bowel syndrome (SBS) occurs after massive intestinal resection, and parenteral nutrition (PN) therapy may be necessary even after a period of adaptation. The purpose of this study was to determine the vitamin status in adults with SBS receiving intermittent PN. METHODS The study was conducted on hospitalized adults with SBS who were receiving intermittent PN therapy (n = 8). Nine healthy volunteers, paired by age and sex, served as controls. Food ingestion, anthropometry, plasma folic acid, and vitamins B(12), C, A, D, E, and K were evaluated. RESULTS The levels of vitamins A, D, and B(12) in both groups were similar. SBS patients presented higher values of folic acid (21.3 ± 4.4 vs 14.4 ± 5.2, P = .01) and lower values of vitamin C (0.9 ± 0.4 vs 1.2 ± 0.3 mg/dL, P = .03), α-tocopherol (16.3 ± 3.4 vs 24.1 ± 2.7 µmol/L, P < .001), and phylloquinone (0.6 ± 0.2 vs 1.0 ± 0.5 nmol/L, P < .03). Eight-seven percent of patients had vitamin D deficiency, and all patients presented with serum vitamin E levels below reference values. CONCLUSIONS Despite all efforts to offer all the nutrients mentioned above, SBS patients had lower serum levels of vitamins C, E, and K, similar to those observed in patients on home PN. These findings suggest that the administered vitamins were not sufficient for the intermittent PN scheme and that individual adjustments are needed depending on the patient's vitamin status.