脓毒症危重患者粪便短链脂肪酸的研究。

IF 3.4 4区 医学 Q2 NUTRITION & DIETETICS Journal of the American College of Nutrition Pub Date : 2020-11-01 Epub Date: 2020-03-12 DOI:10.1080/07315724.2020.1727379
Beatriz E Valdés-Duque, Nubia A Giraldo-Giraldo, Ana M Jaillier-Ramírez, Adriana Giraldo-Villa, Irene Acevedo-Castaño, Mónica A Yepes-Molina, Janeth Barbosa-Barbosa, Carlos J Barrera-Causil, Gloria M Agudelo-Ochoa
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引用次数: 19

摘要

目的:测定危重症脓毒症患者粪便短链脂肪酸(SCFAs)的浓度,并比较危重症患者与对照组的结果。方法:本描述性、多中心、观察性研究在五家卫生机构进行。在为期6个月的研究期间,纳入了入住重症监护病房(ICU)并符合纳入标准的重症脓毒症患者,并为每位患者招募了一名按年龄和性别配对的对照组。从每个参与者身上收集一份自然粪便样本,使用气相色谱仪连接质谱仪(Agilent 7890/MSD 5975 C)测量scfa浓度。结果:最终样本包括44例患者和45例对照组。各组患者年龄、性别分布差异无统计学意义(p > 0.05)。根据体重指数(BMI),危重患者中营养不良更为普遍,对照组中体重指数最常被归类为超重(p = 0.024)。危重患者组丙酸、乙酸、丁酸、异丁酸浓度显著低于对照组(p = 0.000)。患者与结局变量(并发症、ICU住院时间和出院条件)无相关性,在ICU入院时诊断为感染的患者,丁酸和异丁酸浓度相对于其他诊断标准显著降低(p结论:结果证实重症脓毒症患者粪便SCFAs浓度明显低于对照组。由于其在肠道完整性、屏障功能和抗炎作用中的作用,维持SCFAs的浓度在重症患者的ICU护理方案中可能是重要的。
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Stool Short-Chain Fatty Acids in Critically Ill Patients with Sepsis.

Objective: To determine the concentration of stool short-chain fatty acids (SCFAs) in critically ill patients with sepsis and to compare the results between the critically ill patient and the control group.Methods: This descriptive, multicenter, observational study was conducted in five health institutions. Over a 6-month study period, critically ill patients with sepsis who were admitted to the intensive care unit (ICU) and met the inclusion criteria were enrolled, and a control, paired by age and sex, was recruited for each patient. A spontaneous stool sample was collected from each participant and a gas chromatograph coupled to a mass spectrometer (Agilent 7890/MSD 5975 C) was used to measure the concentrations SCFAs.Results: The final sample included 44 patients and 45 controls. There were no differences in the age and sex distributions between the groups (p > 0.05). According to body mass index (BMI), undernutrition was more prevalent among critically ill patients, and BMI in control subjects was most frequently classified as overweight (p = 0.024). Propionic acid, acetic acid, butyric acid, and isobutyric acid concentrations were significantly lower in the critically ill patient group than in the control group (p = 0.000). No association with outcome variables (complications, ICU stay, and discharge condition) was found in the patients, and patients diagnosed with infection on ICU admission showed significant decreases in butyric and isobutyric acid concentrations with respect to other diagnostic criteria (p < 0.05).Conclusions: The results confirm significantly lower concentrations of stool SCFAs in critically ill patients with sepsis than in control subjects. Due to its role in intestinal integrity, barrier function, and anti-inflammatory effect, maintaining the concentration of SCFAs may be important in the ICU care protocols of the critical patient.

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期刊介绍: The Journal of the American College of Nutrition accepts the following types of submissions: Original and innovative research in nutrition science with useful application for researchers, physicians, nutritionists, and other healthcare professionals with emphasis on discoveries which help to individualize or "personalize" nutrition science; Critical reviews on pertinent nutrition topics that highlight key teaching points and relevance to nutrition; Letters to the editors and commentaries on important issues in the field of nutrition; Abstract clusters on nutritional topics with editorial comments; Book reviews; Abstracts from the annual meeting of the American College of Nutrition in the October issue.
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