活体小肠移植受体术后营养支持对血浆游离脂肪酸的影响  

The Effect of Nutrition on Plasma Free Fatty Acid in Recipient of Living-related Small Bowel Transplantation

作　　者：董光龙[1] 王为忠[1] 吴国生[1] 宋维亮[1] 李晓晔[2] 

机构地区：[1]第四军医大学西京医院胃肠外科 [2]第四军医大学化学教研室

出　　处：《中国临床营养杂志》2003年第4期284-287,共4页Chinese Journal of Clinical Nutrition

摘　　要：目的观察我国首例和第2例活体小肠移植受体肠外与肠内营养支持对血浆游离脂肪酸的影响。方法采用气相色谱法测定活体小肠移植受体术前和术后1、4、7、14、30、和45d血浆游离脂肪酸的变化。结果受体血浆游离脂肪酸水平在术后1、4d下降后,在术后7～14d始逐渐接近甚至超过术前水平,且在血浆游离脂肪酸水平的变化上,从全部为肠外营养、肠外营养为主到肠内营养为主甚至全部为肠内营养的过度中均未显示显著的下降。结论小肠移植后受体在给予肠外营养的次日同时行循序渐进的肠内营养,不仅可为机体提供充分的能量,而且能有效地纠正血浆游离脂肪酸浓度的降低,尤其有效地防止了小肠移植后早期必需脂肪酸的缺乏,发挥游离脂肪酸如花生四烯酸C20∶4及其衍生物PGE2、TXA2和LTB4等在免疫系统细胞功能调节中的重要作用。Objective To investigate the effect of nutrition support on plasma free fa tty acid in the first and the second recipients of living-related small bowel transplantation.Methods The level of plasma FFAs includ ing C 14 ,C 16 ,C 18:1 ,C 18:2 and C 20:4 were measured by gas chromatography preoperatively and on1,4,7,10, 14,30and45postoperative days(POD).Results The plasma concentrations of FFAs C 14 ,C 16 ,C 18:1 ,C 18:2 and C 20:4 in two cases decreased on1and4POD,but recovered and even higher than the preoperative value after7and14POD.There were no significant change when tota l or major energy source shifted from PN to EN for the recipients.Conclusions P N and earlier EN(1POD)support step by step not only provided sufficient energ y for host,but also corrected the lower concentration FFAs in plasma effectivel y.And especially it could prevent the deficiency of free fatty acids in plasma after SBT and get FFAs and its' derivatives(PGE 2 ,TXA 2 and LTB 4 etc.)to produce a marked effect on regulated function of immunological cel ls.

关 键 词：活体小肠移植 营养支持 游离脂肪酸 肠外营养 肠内营养 

分 类 号：R459.3[医药卫生—治疗学]