不同脂肪乳剂对肠外营养患者肝脏功能的影响研究  

Effects of Three Different Triglycerides on Hepatic Function in Parenteral Nutrition Patients

作　　者：罗华梁 罗哲[2] 

机构地区：[1]浙江省临海市第二人民医院麻醉科,317016 [2]复旦大学附属中山医院外科监护中心

出　　处：《中国全科医学》2011年第10期1104-1106,共3页Chinese General Practice

摘　　要：目的探讨结构脂肪乳剂、中长链脂肪乳剂和长链脂肪乳剂对肠外营养患者肝脏功能的影响。方法选择拟行腹部手术且需肠外营养治疗超过5 d的患者60例,随机分为3组:A组(20例)接受结构脂肪乳剂,B组(20例)接受中长链脂肪乳剂,C组(20例)接受长链脂肪乳剂进行肠外营养治疗。在开始肠外营养前(T0)、输注24 h(T1)、48 h(T2)、72 h(T3)、120 h(T4)测定α-谷胱甘肽S转移酶(α-GST)、丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)及血浆三酰甘油水平。结果与A组比较,B组[T3:(9.4±9.9)μg/L,T4:(14.6±19.5)μg/L]和C组[T3:(14.2±20.8)μg/L,T4:(22.4±39.3)μg/L]的α-GST水平在T3、T4时点明显增高,差异有统计学意义(P<0.05)。在T3、T4时点A组血三酰甘油水平明显低于B组和C组,差异有统计学意义(P<0.05)。而AST、ALT水平各组间比较差异无统计学意义(P>0.05)。结论结构脂肪乳剂能够保持肝脏功能的完整性,而中长链脂肪乳剂和长链脂肪乳剂输注会引起亚临床肝损伤。Objective To determine the effects of fat emulsions of structured triglycerides（ST）,medium/long chain triglycerides（MCT/LCT） and LCT on hepatic function of patients with parenteral nutrition.Methods A total of 60 patients scheduled for major abdominal surgery and demand for more than 5 days parenteral nutrition were allocated to 3 groups randomly.The patients in group A（n=20） received structured triglycerides;group B（n=20）,MCT/LCT;and group C（n=20）,LCT.Before the initiation of nutrition（T0）,24 h（T1）,48 h（T2）,72 h（T3） and 120 h（T4） after the infusion the following parameters were measured：alpha-glutathione S-transferase（α-GST）,alanine aminotransferase（ALT）,aspirate aminotransferase（AST）,and serum triglycerides.Results Compared with group A,the α-GST levels at T3 and T4 in group B [T3：（9.4±9.9）μg/L,T4：（14.6±19.5）μg/L] and group C [T3：（14.2±20.8）μg/L,T4：（22.4±39.3）μg/L] significantly increased（P0.05）.The triglyceride level of group A at T3 and T4 was significantly lower than those in group B and C（P0.05）.However there was no significant difference in AST and ALT level among the 3 groups（P0.05）.Conclusion Hepatic integrity was well remained with The administration of structured triglycerides can maintain the hepatic integrity;while both MCT/LCT and LCT fat emulsion may cause subclinical hepatic injury.

关 键 词：脂肪乳剂 肠外营养 α-谷胱甘肽S转移酶 

分 类 号：R459.3[医药卫生—治疗学]