Department of Internal Medicine, Nishimino Kosei Hospital, 986 Oshikoshi, Yoro-cho, Yoro-gun, Gifu 503-1394, Japan.
Clin Nutr. 2011 Oct;30(5):585-9. doi: 10.1016/j.clnu.2011.04.008. Epub 2011 May 18.
BACKGROUND & AIMS: Trace element deficiencies are known to occur during long-term enteral nutrition feeding. We compared the serum concentrations of trace elements between patients treated with gastrostomy and those treated with jejunostomy.
Our subjects were 36 patients who underwent percutaneous endoscopic gastrostomy (PEG group) and 23 patients who underwent percutaneous endoscopic jejunostomy (PEJ group) and were maintained with enteral tube feeding for more than one year. The serum concentrations of copper, zinc, selenium, and iron were measured in the two groups. Clinical manifestations and the effectiveness of supplementation therapy against copper deficiency were also investigated.
From 6 months after the onset of enteral feeding, the copper concentration of the PEJ group was significantly decreased compared with that of the PEG group (p<0.001). There were no significant differences in the concentrations of zinc, selenium, or iron between the two groups. Severe copper deficiency was observed in 6 patients of the PEJ group and was accompanied with neutropenia and anemia. The copper deficiency was successfully treated in all of these patients by supplementation with 10-40 g of cocoa powder a day which was equivalent to a total daily dose of 1.36-2.56 mg of copper.
Prolonged PEJ tube nutrition tends to result in copper deficiency, and cocoa supplementation is effective for treating such copper deficiency.
长期肠内营养喂养会导致微量元素缺乏。我们比较了经胃造口术和空肠造口术治疗的患者的血清微量元素浓度。
我们的研究对象为 36 例行经皮内镜胃造口术（PEG 组）和 23 例行经皮内镜空肠造口术（PEJ 组）的患者，两组均进行了超过 1 年的肠内管饲。测量了两组患者的血清铜、锌、硒和铁浓度。还调查了铜缺乏的临床表现和补充治疗的效果。
从肠内喂养开始后 6 个月起，PEJ 组的铜浓度明显低于 PEG 组（p<0.001）。两组锌、硒或铁浓度无显著差异。6 例 PEJ 组患者出现严重铜缺乏，伴有中性粒细胞减少和贫血。这些患者通过每天补充 10-40 克可可粉（相当于每天 1.36-2.56 毫克铜）成功治疗了铜缺乏症。
长期 PEJ 管饲营养易导致铜缺乏，可可补充剂对治疗铜缺乏有效。
