功能性便秘儿童粪便短链脂肪酸的气相色谱分析及临床意义

Establishment of the finger- print of the short chain fatty acid in human fecal samples based on gas chromatography in functional constipation in childhood

目的应用分析化学技术建立正常儿童粪便样本中短链脂肪酸的指纹图谱，并分析其在功能性便秘（FC）儿童中的变化，探讨肠道短链脂肪酸变化在儿童功能性便秘中的作用。方法研究对象分为对照组和便秘组，对照组35例，平均年龄6岁，便秘组i5例，平均年龄6．5岁，均符合儿童功能性便秘罗马III标准。取所有儿童粪便样本提取短链脂肪酸（SCFA），应用气相气谱技术（GC）对SCFA的含量进行定量检测。结果对照组儿童每克干粪中SCFA的含量为（51．州=17．62）mg／g，其中各SCFA的含量依次为：乙酸，丁酸，丙酸，异丁酸和异戊酸；与对照组相比，便秘儿童每克干粪中SCFA总量明显减少，差异有统计学意义（P〈0．01）；其中乙酸，丙酸和丁酸的含量减少，异丁酸和异戊酸含量增加，其含量顺序依次为：异丁酸最多，异戊酸次之，乙酸，丙酸和丁酸含量最低；便秘组粪便中SCFA浓度（87．29±33．42）mg／L较对照组的（17．36±8．12）mg／L增高，差异有统计学意义（P〈0．01）；结论功能性便秘儿童粪便中的短链脂肪酸含量减少，比例失调，但浓度升高，功能性便秘的产生可能与肠道内短链脂肪酸吸收过度以及局部的短链脂肪酸浓度升高有关。

Objective To investigate the formation and proportion of the short-chain fatty acids （SCFA） in normal and functional constipation （FC） children. Methods Fifty children were divided into control group （15） and FC group （35）. SCFA were extracted from children＇s stool, and quantita tively analyzed by gas chromatography （GC）. Results Of control group, SCFA of stool was 51.89 ± 17. 62 （mg/g） ; among the SCFA, acetic acid was the richest, butyric acid was the second richest, fol lowed by propanoic acid third, isobutyric acid fourth, and isopentoic acid the last. Compared with the SCFA of control group, the stool SCFA in FC group significantly decreased; among the SCFA, isobu tyric acid was the richest, isopentoic acid second, and then came propanoic acid, acetic acid, and butyric acid. The content of acetic acid, butyric acid and propanoic acid decreased, while the isobutyric acid and isopentoic acid increased in FC group. The concentration of SCFA in FC group was 87. 29 ± 33. 42 mg/L, which was significantly higher than 17. 36 ± 8. 12 mg/L of the control group （P〈0. 01 ）. Conclusions The stool SCFA increases and disproportions in FC patients, which may contribute to the pathogenesis of FC in children.