短肠综合征患儿血清微量营养素状况评价

目的评价短肠综合征患儿不同状态下的血清微量营养素状况。方法收集并分析2004年4月至2006年7月间收治并获随访的17例短肠综合征患儿的临床资料。结果本组患儿年龄为3个月至18岁。其中完全脱离肠外营养（PN）11例，6例仍靠部分PN支持；保留回盲瓣11例，无回盲瓣6例；剩余小肠在75cm以上者5例，小于或等于75cm者12例。采用高效液相法测定血清维生素A、E和β-胡萝卜素水平。11例已脱离PN的患儿中有9例测定了血清铁、锌和铜。维生素低于参考值的发生率：维生素A占23．5％，维生素E占35．3％，β-胡萝卜素占58．8％。在未脱离PN、无回盲瓣和剩余小肠小于或等于75cm的患儿中，维生素A和β-胡萝卜素低于参考值的发生率较高。在脱离PN和剩余小肠大于75cm的患儿，维生素E低于参考值发生率较高。而在有或无回盲瓣患儿中，上述的发生率差异无统计学意义。3例血清锌浓度低于正常．1例血清铁浓度低于正常。结论短肠综合征患儿无论在PN支持时还是恢复正常饮食时，均可能发生微量营养素缺乏，应密切随访并补充有关微量营养素。

Assessment of serum micronutrients in children with short bowel syndrome

OBJECTIVE: To assess micronutrients level in children with short bowel syndrome. METHODS: Clinical data of 17 children with short bowel syndrome from April 2004 to July 2006 were collected. They received the measurement of serum vitamin A, E and - carotene by high performance liquid chromatography (HPLC). RESULTS: There were 9 boys and 8 girls with age range of 3 months to 18 years. Eleven children did not need parenteral nutrition (PN), and 6 still depended on PN. Six cases were free of ileocolic valve and 11 cases had ileocolic valve. The length of remaining intestine was more than 75 cm in 5 patients and less than 75 cm in 12 patients. Among 11 cases without PN, 9 were tested for serum iron, zinc and copper levels. Their incidences of below the reference value of vitamin A, E and beta - carotene were 23.5%, 35.3% and 58.8%, respectively. The incidences of below the reference value of vitamin A and beta - carotene were higher in patients with weaned PN, less than 75 cm remaining intestine and without ileocolic valve. The patients with more than 75 cm remaining intestine and still with PN had a higher incidence of below the reference of vitamin E, but the incidence was similar in the patients with or without ileocolic valve. Serum zinc was lower than normal level in 3 cases and serum iron was low in 1 case. CONCLUSION: Supplement of extra micronutrients is essential for short bowl syndrome patient whatever they receive the PN or have normal diets, and follow- up is recommended.