大腸前処置法の栄養評価としてのレチノール結合蛋白の有用性の検討

大腸内視鏡検査の前処置を栄養面から評価する目的で前処置前後にrapid turnover proteinである血中レチノール結合蛋白の変動を検討した｡前日に普通食を用い,当日ニフレックを使用した10例,検査1日前に低残渣食を用いた27例,通常の前処置では良好な腸管洗浄が得られないために検査前2日間低残渣食を用いた27例の3群について,前処置開始前と検査終了後に血中レチノール結合蛋白の変動をみたところ,検査前2日間低残渣食服用群で有意の低下を認めた｡前日普通食群では検査前後で変化を認めず,1日低残渣食服用群では低下傾向を認めたが,有意差は認めなかった｡これまで前処置の成否は腸管洗浄度の面で評価されてきたが,血中レチノール結合蛋白を目標として用いることにより栄養面から評価することができることが考えられた。

The objective of this study was to evaluate the usefulness of retinol binding protein (RBP), one of rapid turnover proteins, for the assessment of nutritional aspect of the preparation for colonoscopy. Blood samples were drawed before the preparation and after the colonoscopic examination and serum RBP was determined by laser nephrometory. Group A consisted of 10 patients who were administered intestinal lavage solution (Niflec) without no low residual diet. Group B consisted of 27 patients who were adminstered low residual diet for 1 day. Group C consisted of 27 patients who were administered low residual diet for the two consecutive days before colonosocopic examination with intestinal lavage solution and magnesium citrate because sufficient cleanup of intestine were not expected by using the ordinary preparations. The values of serum RBP significantly decreased in group C after the preparation although no significant changes were observed in group A and Group B. We emphasized in estimating the preparation for the colonoscopy assessment of nutrition using serum RBP was needed as well as colonic cleaning.