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危重症脓毒症患者粪便短链脂肪酸。

Stool Short-Chain Fatty Acids in Critically Ill Patients with Sepsis.

机构信息

Bioscience Research Group, Institución Universitaria Colegio Mayor de Antioquia - IUCMA, Medellín, Antioquia, Colombia.

Food and Human Nutrition Research Group, Universidad de Antioquia - UdeA, Medellín, Antioquia, Colombia.

出版信息

J Am Coll Nutr. 2020 Nov-Dec;39(8):706-712. doi: 10.1080/07315724.2020.1727379. Epub 2020 Mar 12.

DOI:10.1080/07315724.2020.1727379
PMID:32163012
Abstract

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. 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. The final sample included 44 patients and 45 controls. There were no differences in the age and sex distributions between the groups ( > 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 ( = 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 ( = 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 ( < 0.05). 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.

摘要

目的

确定脓毒症重症患者粪便短链脂肪酸(SCFA)的浓度,并比较重症患者和对照组之间的结果。

方法

本描述性、多中心、观察性研究在五家医疗机构进行。在 6 个月的研究期间,纳入了入住重症监护病房(ICU)且符合纳入标准的脓毒症重症患者,并为每位患者配对了年龄和性别相匹配的对照组。每位参与者采集了一份自然粪便样本,并使用气相色谱-质谱联用仪(Agilent 7890/MSD 5975C)测量 SCFA 浓度。最终样本包括 44 名患者和 45 名对照。

结果

两组间的年龄和性别分布无差异( > 0.05)。根据体重指数(BMI),重症患者中营养不良更为常见,而对照组中 BMI 最常被归类为超重( = 0.024)。与对照组相比,重症患者组丙酸、乙酸、丁酸和异丁酸的浓度显著降低( = 0.000)。

结论

脓毒症重症患者粪便 SCFA 浓度明显低于对照组。由于 SCFA 在肠道完整性、屏障功能和抗炎作用中的作用,维持 SCFA 浓度可能对重症患者的 ICU 护理方案很重要。

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