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中链甘油三酯对手术后接受肠外营养患者代谢的影响 被引量:11

Metabolic effects of medium-chain triglycerides in parenteral nutrition after surgery
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摘要 目的 比较长链甘油三酯 (LCT)和中链甘油三酯 (MCT) 2种脂肪乳的代谢效应差异。方法  2 4例胃、结肠手术患者和 6例志愿者参加本研究 ,均有知情同意。患者随机分为 2组 ,分别接受含 5 0 %MCT或单纯LCT的肠外营养。测定前臂动静脉血中甘油三酯的浓度差及氮平衡。 结果MCT组肌肉利用脂肪乳的能力明显提高 ,氮平衡也有所改善 ,且术后体重减轻较少。在脂肪乳廓清试验中发现 ,血清酮体浓度MCT组 [(0 .0 6 3± 0 .0 0 4)mmol/L]明显高于LCT组 [(0 .0 39± 0 .0 0 2 )mmol/L]。氮储存的增加与酮体和胰岛素水平的增加相关。 结论 含 5 0 %MCT的脂肪乳用于肠外营养是安全的 。 Objective To investigate the difference between long chain triglycerides (LCT)and medium chain triglyceride (MCT). Methods Twenty four surgical patients and 6 volunteers were studied. These subjects were randomly assigned to receive parenteral nutrition with MCT or LCT emulsion. Their arterial and venous concentrations were measured across the forearm. Results Muscle utilization was significantly improved with MCT administration. In fat clearance test, serum ketone concentrations were significantly higher in the MCT group than in the LCT group. The improvement in nitrogen retention may be associated with the increasing of ketone and insulin levels. Conclusions Fat emulsions containing 50%MCT are safe for use in parenteral nutrition and provide an alternate fuel that improves protein metabolism.
出处 《中华外科杂志》 CAS CSCD 北大核心 2001年第9期694-697,共4页 Chinese Journal of Surgery
基金 卫生部重点项目( 970 10 2 0 4) 高等教育基金项目(90 0 40 )
关键词 脂肪乳剂 静脉注射 胃肠外营养 脂肪廓清试验 中链甘油三脂 Fat emulsions,intravenous Parenteral nutrition Fat clearance test
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参考文献6

  • 1Wilmore DW,Moylan JA,Helmkap GM,et al.Clinical evaluation of 10% inravenous fat emulsion for parenteral nutrition in themally injured patients[].Annals of Surgery.1973
  • 2Hessov I,Melsen F,Haug A.Postmortem findings in three patients treated with intravenous fat emulsion[].Archives of Surgery.1979
  • 3Carpentier YA.Intravascular metabolism of fat emulsions: the arvid wretlind lecture 1988[].Clinical Nutrition.1989
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  • 5Ball MJ.Hematological and biochemical effects of parenteral nutrition with mediumchain triglycerides: comparison with long-chain triglycerides[].The American Journal of Clinical Nutrition.1991
  • 6Abumrad NN,Rabin D,Diamond MP,et al.Use of a heated superficial hand vein as an alernative site for the measurement of amino acid concentrations and for the study of glucose and alanine kinetics in man[].Metabolism.1981

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