中、长链脂肪乳剂对肝硬变家兔脂肪廓清的影响  

Elimination of the medium vs long chain triglycerides in the rabbits with liver cirrhosis

作　　者：秦环龙[1] 吴肇汉[1] 

机构地区：[1]上海医科大学中山医院普外科

出　　处：《肠外与肠内营养》1998年第1期20-25,共6页Parenteral & Enteral Nutrition

摘　　要：目的：观察中、长链脂肪乳剂对肝硬变家兔脂肪廓清的影响。方法：２１只胆源性肝硬变家兔随机分为两组，一组为长链脂肪乳剂（ＬＣＴ）－肠外营养（ＰＮ）组（简称ＬＣＴ组，ｎ＝１０），另一组为中／长链混合脂肪乳剂（ＭＣＴ／ＬＣＴ）－ＰＮ组（简称ＭＣＴ组，ｎ＝１１）。两ＰＮ组所含非蛋白热能及氮量均相等。ＬＣＴ组能源由５０％葡萄糖和脂肪乳剂——２０％Ｉｎｔｒａｌｉｐｉｄ提供；ＭＣＴ组脂肪乳剂由２０％ＬｉｐｏｆｕｎｄｉｎＭＣＴ／ＬＣＴ提供。糖脂提供能源比为１∶１，连续ＰＮ７天。结果：①无论肝硬变前后，ＭＣＴ组ＴＧ的Ｋ２和ｔ１／２均明显优于ＬＣＴ组（Ｐ＜０．０１）；亚油酸和亚麻酸的Ｋ２和ｔ１／２也明显优于ＬＣＴ组（Ｐ＜０．０１）。②辛酸和癸酸除在注后５ｍｉｎ之外，余各时相点均低于最小检测值。③ＭＣＴ组血中β－羟丁酸浓度在注后５ｍｉｎ即有明显升高，与ＬＣＴ组相比差异显著（Ｐ＜０．０１），但其下降速度快，９０ｍｉｎ已接近基础值水平；而ＬＣＴ组ＰＮ前后均无明显变化。④ＭＣＴ／ＬＣＴ乳剂体内清除迅速，且不受肝硬变的影响，也是一种良好的酮体源。结论：ＭＣＴ／ＬＣＴ乳剂可能是应用于肝硬变较为理想的脂肪能源，为临床选择最佳营养支持提供实验依?s Objective:To study the eliminatin of medium vs long chain triglycerides in the rabbits with liver cirrhosis. Methods:Twenty one of 40 rabbits were induced cholostatic liver cirrhosis,rabbits were divided into two groups randomly:LCT PN group(LCT group, n =10),MCT/LCT PN group(MCT group, n =11).Two PN groups contain the same nonprotein calorine and nitrogen.The lipid energy souces was provided with 20% Intralipid in the group LCT,and 20% Lipofundin in group MCT,the ratio of the glucose vs fat emulsion was 1∶1.PN was continued 7 days. Results:Intravenous fat tolerance test(IVFTT) showed that K 2 markedly increased and t 1/2 decreased in group MCT as compared with group LCT( P <0.01).Serum β hydroxybutyrate(β HBA) in group MCT was markedly increased after infusion 5,30,60min as compared with basic and normal control,but β HBA markedly decreased at 90min in group MCT. Conclusion:MCT/LCT are faster elimination:complete,more rapid,and strongly ketogenic,MCT/LCT seems an ideal energy for liver cirrhosis.

关 键 词：中链脂肪乳剂 长链脂肪乳剂 脂肪廓清 肝硬化 

分 类 号：R575.2[医药卫生—消化系统] R459.3[医药卫生—内科学]