Kong Wencheng, Wang Jian, Ying Rongchao, Li Yousheng, Jin Huicheng, Mao Qi, Yao Danhua, Guo Mingxiao
Department of Gastroenterological Surgery, Hangzhou First People's Hospital, School of Clinical Medicine, Nanjing Medical University, Hangzhou, 310006, China.
Intestinal Rehabilition and Transplant Center, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, China.
BMC Gastroenterol. 2016 Jan 29;16:12. doi: 10.1186/s12876-016-0425-4.
Fundamental researches suggest that ileum presents greater adaptive potential than the jejunum. However, few studies estimate the association between ileum and adaptive potential in human. To discover the association, we conducted this matched case-control study.
A 1:2 pair-matched, case-control study was conducted from January 1, 2001 to January 1, 2015 in Intestinal Rehabilition and Transplant Center. The case group was ileum predominated (IP) group and the control group was jejunum predominated (JP) group. Demographic data, medical history and progression of each patient were collected.
There were 24 IP cases and 48 JP controls in this study. The cumulative probabilities of parenteral nutrition (PN) weaning in IP group were higher than that in JP group. The Bristol stool scale scores of IP group were lower than that of JP group at third month. The Cox proportional hazards regression model confirmed that IP had a higher odds of PN weaning (OR = 2.69; 95 % CI: 1.27, 5.70, p = 0.01) as compared with JP group. The conditional logistic regression with 1:2 matching also confirmed IP group had a higher odds (OR = 4.84; 95 % CI: 2.02, 11.56, p <0.01).
Our results indicated that ileum presents greater adaptive potential than the jejunum in nutrition and fluid absorption. And a potential anatomic subtype of short bowel syndrome was proposed. Further research need to be conducted to more fully understand the adaptive potential of ileum besides nutrition and fluid absorption.
基础研究表明，回肠比空肠具有更大的适应潜力。然而，很少有研究评估人类回肠与适应潜力之间的关联。为了发现这种关联，我们进行了这项匹配病例对照研究。
2001年1月1日至2015年1月1日在肠道康复与移植中心进行了一项1:2配对的病例对照研究。病例组为回肠为主（IP）组，对照组为空肠为主（JP）组。收集了每位患者的人口统计学数据、病史和病情进展情况。
本研究中有24例IP病例和48例JP对照。IP组肠外营养（PN）撤机的累积概率高于JP组。IP组在第三个月时的布里斯托大便量表评分低于JP组。Cox比例风险回归模型证实，与JP组相比，IP组PN撤机的几率更高（OR = 2.69；95%CI：1.27，5.70，p = 0.01）。1:2匹配的条件逻辑回归也证实IP组的几率更高（OR = 4.84；95%CI：2.02，11.56，p <0.01）。
我们的结果表明，在营养和液体吸收方面，回肠比空肠具有更大的适应潜力。并提出了一种短肠综合征的潜在解剖学亚型。除了营养和液体吸收外，还需要进一步研究以更全面地了解回肠的适应潜力。
