Gut mucosal atrophy after a short enteral pasting period in critically ill patients
Gut mucosal atrophy after a short enteral pasting period in critically ill patients
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DOI：
10.1016/s0883-9441(99)90017-5
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发表时间：
1999-06-01
影响因子：
3.7
通讯作者：
Vargas, C
中科院分区：
文献类型：
--
作者：
Hernandez, G;Velasco, N;Vargas, C
目的：本研究的目的是评估存在的肠粘膜萎缩和粘膜通透性的变化在危重病人经过短暂的禁食period.Materials和方法：15例危重病人进行了一段时间的肠内禁食至少4天（平均7.8天）。在开始肠内营养前一天，我们进行了以下测量：间接量热法、血清白蛋白、前白蛋白和淋巴细胞计数。我们还进行了十二指肠内镜活检，组织病理学和粘膜形态学分析，包括绒毛高度和隐窝深度。采用乳果糖-甘露醇试验评价肠道通透性。28例健康志愿者作为十二指肠活检或乳果糖-甘露醇试验的对照。记录患者的临床资料，如禁食时间、严重程度评分和既往肠外营养支持情况。结果：与对照组相比，我们发现患者的肠粘膜萎缩，表现为绒毛高度和隐窝深度减少。患者还表现出异常乳果糖-甘露醇试验。形态学变化与渗透性无关。此外，我们没有发现乳果糖-甘露醇试验和粘膜形态测量与临床data.Conclusions的结果之间的相关性：我们发现，短期的肠内禁食与显着的十二指肠粘膜萎缩和肠道通透性异常的危重患者。W.B，Saunders Company版权所有（C）1999。
Purpose: The purpose of this study was to evaluate the presence of gut mucosal atrophy and changes in mucosal permeability in critically ill patients after a short fasting period.Materials and Methods: Fifteen critically ill patients underwent a period of enteral fasting of at least 4 days (mean 7.8 days). We took the following measurements the day before initiating enteral nutrition: indirect calorimetry, serum albumin, prealbumin, and lymphocyte count. We also performed a duodenal endoscopic biopsy with histopathological and mucosal morphometric analysis including villus height and crypt depth. The lactulose-mannitol test was performed to assess gut permeability, A total of 28 healthy volunteers served as controls for duodenal biopsy or lactulose-mannitol test. Clinical data, such as length of fasting, severity score, and previous parenteral nutritional support, were recorded,Results: We found gut mucosal atrophy, expressed as a decrease in villus height and crypt depth, in patients compared with controls. The patients also exhibited an abnormal lactulose-mannitol test. Morphometric changes did not correlate with permeability. Further, we found no correlation between the results of the lactulose-mannitol test and of mucosal morphometry with clinical data.Conclusions: We found that a short period of enteral fasting was associated with significant duodenal mucosal atrophy and abnormal gut permeability in critically ill patients. Copyright (C) 1999 by W.B, Saunders Company.