摘要
目的 观察两种不同碳链脂肪乳剂对肝脏外科患者术后脂肪及肝脏能量代谢的影响。方法 选择肝脏外科患者 2 5例 ,随机分为 2组 :给予肠外营养 ,长链脂肪乳剂组 (LCT组 ) 12例 ,中 /长链脂肪乳剂组 (MCT组 ) 13例。LCT组脂肪乳剂为 2 0 %英脱利匹特 (Intralipid) ,MCT组为 2 0 %力保肪宁 (Lipofundin) ,连续观察 1周。在术前 ,术后 1d、7d作脂肪廓清实验 (IVFTT) ,并测定血及尿液中肉毒碱 (CNT)以及动脉血酮体浓度及比率 (AKBR)的变化。结果 MCT组清除率为LCT组的 1倍 ,半衰期为LCT组的 1/ 2 ;术后血CNT明显升高 ,尿排出减少 ,术后 7d时 ,LCT组血CNT高于MCT组 ,尿CNT低于MCT组 ,P <0 0 5 ;血AKBR术后 1d明显下降 ,随后MCT组逐渐回升 ,在术后 7d时 ,MCT组明显高于LCT组 ,P <0 0 1。结论 MCT组体内清除迅速 ,对CNT依赖较小 ,并对肝脏能量代谢有保护作用。
Objective To study the influence of Lipofundin vs Intralipid on lipid energy metabolism of cirrhotic patients undergoing surgery.Methods Twenty five patients with liver disease were randomly assigned to two PN groups:LCT group( n =12) and MC/LCT group ( n =13). Fat energy in group LCT was supplied by 20% Intralipid,Group MCT/LCT was supplied by 20% Lipofundin. All patients were on parenteral nutrition for 7 days. Intravenous fat tolerance test (IVFTT) was measured at pre op,post op d1、post op d7. Carnitine (CNT) level in serum and urine,and AKBR were tested at the pre op、post op d1、d7. Results The elimination rate of the MCT was faster than that of LCT at pre op and post op d7, the elimination rate of LCT at post op d1 was faster than that of at pre op and post op d7. Serum CNT increased in both groups, urine CNT markedly decreasd at postoperation, but in LCT group CNT was at lower level as compared with MCT group at post op d7, P <0 05. AKBR was markedly decreased in both groups post op, but at post op d7,AKBR in MCT group was higher than in LCT group, P <0 01.Conclusions These results indicated that Lipofundin was an ideal energy source for the cirrhotic patients.
出处
《中华普通外科杂志》
CSCD
北大核心
2001年第4期240-242,共3页
Chinese Journal of General Surgery
