不同甘油三酯对肠瘘病人代谢和免疫的影响

作者比较了中／长链甘油三酯（ＭＣＴ／ＬＣＴ）及长莲甘油三酯（ＬＣＴ）对肠瘘病人代谢及免疫功能的影响。将１２例男性肠瘘病人按交叉分组法分成两组，一组先给予ＬＣＴ５ｄ，后给予ＭＣＴ／ＬＣＴ５ｄ，另一组反之。第０，６，１１天分别检测代谢及免疫指标。结果发现，以脂肪为基础的ＴＰＮ促进肠瘘病人的蛋白合成，改善氮平衡。ＭＣＴ／ＬＣＴ对白蛋白、转铁蛋白、纤维连接蛋白和合成与ＬＣＴ比无明显差异，但对氮平衡及前白蛋     

糖尿病病人中链甘油三酯和长链甘油三酯乳剂的清除比较

作者报告１２例胰岛素非依赖性糖尿病病人对中链甘油三酯（ＭＣＴ组）和长链甘油三酯（ＬＣＴ组）两种乳剂的清除比较。每组各６例。在４ｈ的脂肪输入期间，仅ＭＣＴ组的血清甘油三酯水平进入稳定形态。动力学参数表明，ＭＣＴ组和ＬＣＴ组的表观分布容积（１６３．５０±...     

膳食脂肪和VE对大鼠血浆总胆固醇及甘油三酯的影响

采用析因设计，设两个脂肪水平（产热比为１２％和２５％），两个ＶＥ水平（基础饲料和另加入２００μｇ／ｇα－生育酚），研究了膳食脂肪和ＶＥ对大鼠血浆甘油三酯和总胆固醇含量的影响。结果表明，膳食不加ＶＥ时，高脂组血浆总胆固醇含量明显高于低脂组；当膳食加入ＶＥ时，高脂组血浆总胆固醇量与低脂组无明显差异。不论加ＶＥ与否，高脂食组血浆甘油三酯均高于低脂组；当膳食脂肪含量低时，加ＶＥ组血浆甘油三酯含量低于不加ＶＥ组。结果提示：当膳食脂肪含量较低时，ＶＥ有降血浆甘油三酯作用；当膳食脂肪含量较高时，则ＶＥ降血浆甘油三酯作用不明显；ＶＥ可以降低血浆总胆固醇含量。     

力平脂治疗高甘油三酯血症临床观察

随着物质条件的富裕和生活文化方式的改变 ,高甘油三酯血症的发病率明显增高 ,近年来研究提示高甘油三酯血症与冠心病事件和冠心病死亡有极为密切的关系 ,其与高粘血症、脑卒中等的关系亦日益引起人们的关注 ,为此 ,本文对高甘油三酯血症的人群 ,在非药物治疗的基础上使用调脂药物治疗作一些探讨。1　资料和方法1· 1　一般资料　门诊 6 8例高甘油三酯 (ＴＧ)在3 8ｍｍｏｌ/Ｌ以上的病人 ,男性 4 8例 ,女性 2 0例 ,平均年龄为 5 8岁 (36～ 76岁 )。1·2　治疗方法　⑴将 6 8例高甘油三酯血症病人随机分成两组。一组采用非药物治疗 ,一组在非…     

围手术期中链和长链甘油三酯乳剂的清除动力学比较

本研究以１４例择期胆囊切除术病人为创伤模型，观察创伤前后机体应用中链甘油三酯／长链甘油三酯（ＭＣＴ／ＬＣＴ）和ＬＣＴ乳剂的清除动力学变化。结果表明，脂肪乳剂输入和清除期间无不良反应。术后两种乳剂的清除均加速。ＭＣＴ／ＬＣＴ乳剂输入后血胰岛素浓度明显升高。对血糖的影响可能与脂肪乳剂的代谢速度及胰岛素的影响有关。     

吸烟对老年男性甘油三酯水平的相关性分析

目的：探讨吸烟对老年男性血中甘油三酯水平的影响。方法：对本院2007-2010年就诊的老年男性患者572例的临床资料进行回顾性分析,按吸烟史分为吸烟组与非吸烟组,其中吸烟组468例,非吸烟组104例,比较吸烟组与非吸烟组的血清甘油三酯的水平差异,按甘油三酯水平分为高甘油三酯组327例和正常甘油三酯组245例,并分析影响甘油三酯水平的相关因素。结果：吸烟组甘油三酯平均水平为（3.07±1.29）mmol/L明显高于不吸烟组（1.42±0.45）mmol/L,差异有统计学意义（P〈0.05）。影响甘油三酯水平的相关因素分析表明,体重、吸烟数量、吸烟年限与甘油三酯水平呈正相关（r=0.594,P〈0.05）,而年龄和身高与甘油三酯水平无明显相关性（r=0.037,P〉0.05）,采用Logistic回归分析提示,甘油三酯水平随吸烟数量、吸烟年限的增加而增高。结论：吸烟对老年男性甘油三酯水平具有重要的影响,提倡禁烟。     

中链脂肪酸代谢及其临床意义

长链甘油三酯（ＬＣＴ）的脂肪乳剂在临床应用３０余年，但有些问题尚待解决，如对免疫功能影响、脂肪蓄积、生物活性物质（前列腺素、血栓素等）的变化。近年来，人们对中链甘油三酯（ＭＣＴ）引起普遍关注。ＭＣＴ的代谢特征及临床意义已有较多认识，本文对此作一综述。...     

维生素E与镁对肥胖大鼠糖脂代谢影响的研究

目的观察维生素E(VE)与镁(Mg)对肥胖大鼠糖脂代谢的影响。方法健康Wistar大鼠共74只随机分为5组:正常对照组、高脂高糖组、高脂高糖+VE组、高脂高糖+Mg组和高脂高糖+VE+Mg组。VE和Mg的剂量分别为0.23 g/kg和0.31 g/kg饲料。实验喂养67周处死动物,计算脂肪体重比;检测血脂水平;检测血糖、胰岛素水平,计算胰岛素敏感指数;分析己糖激酶、丙酮酸激酶活性。各结果采用单因素方差分析及析因设计方差分析进行统计。结果高脂高糖组大鼠的体重比正常对照组明显高20%,肥胖大鼠模型建立成功。干预67周后,高脂高糖+VE+Mg组脂体比为13.29%、血浆甘油三酯为0.6 mmol/L,明显低于高脂高糖组的17.24%和1.18 mmol/L(P0.05),且高脂高糖+VE+Mg组甘油三酯水平明显低于高脂高糖+VE组的1.07 mmol/L(P0.05);高脂高糖+VE、高脂高糖+VE+Mg组的己糖激酶活性分别为63.67 U/L和64.61 U/L,较高脂高糖组42.79 U/L和高脂高糖+Mg组44.02 U/L明显增高(P0.05)。结论联合补充VE与Mg可以有效地改善肥胖大鼠脂肪含量及甘油三酯代谢,且降低甘油三酯的作用较单纯补充VE效果显著。此外,其还可以提高肥胖大鼠己糖激酶的活性,且添加VE组较单纯补充Mg组效果更佳。     

力平脂治疗酒精高甘油三酯血症疗效观察

长期较大剂量的饮酒易导致机体脂质代谢紊乱,血清中甘油三酯(ＴＧ)的增高明显超过胆固醇(ＴＣ),多数大样本流行病学研究报告均支持富含高ＴＧ血症的动脉粥样硬化病变过程中起着重要作用【1】。酒精性高甘油三酯血症在停止饮酒半年后,血脂异常状况并未得到纠正。笔者观察了贝特类调脂药力平脂(非诺贝特)及其它降脂药物月见草油丸的治疗效果,现将结果报告如下。1　对象与方法1.1　对象　40岁-50岁男性患者共40例。饮酒史在10年以上。白酒每日超过50ｍｌ,或间断饮酒,每次饮酒量达250ｍｌ左右,且除外其它引起血脂异常的基础疾病,经戒酒、饮…     

压电电导型传感器—动力学法测定血清中甘油三酯

血清中甘油三酯（Ｔｒｉｇｌｙｃｅｒｉｄｅ，ＴＧ）的含量与动脉粥样硬化等疾病的发生发展密切相关，因此，血清中ＴＧ含量测定具有重要临床意义。酶法测定是临床检查中较普遍采用的方法，但血清中游离甘油干扰严重〔１，２〕。本文基于ＴＧ在碱性溶液中水解，导致溶液电...     

结构脂肪乳剂与物理混合的中/长链脂肪乳剂脂肪酸代谢比较研究

目的:比较结构脂肪乳剂(STG)与物理混合的中/长链脂肪乳剂(MCT/LCT)在人体内的脂肪酸代谢情况.方法:40例健康志愿者随机分为STG组和MCT/LCT组,每组20例.分别于早晨6h内匀速输注20%力文脂肪乳剂和20%力保肪宁脂肪乳剂1.0 g/(kg·次).并于给药前和给药后2、4、6和24 h留取血标本测定血...     

结构脂肪乳剂在肝硬化病人中的产热及代谢作用

目的：通过比较结构脂肪乳剂与长链脂肪乳剂在肝硬化病人的产热及代谢效应，以评估结构脂肪乳剂在肝硬化病保的应用价值。方法：选择１６例经病理证实为肝硬化病人作为研究对象，进行随机交叉研究。第一组７例病人分别连续输注２０％Ｉｎｔｒａｌｉｐｉｄ或２０％Ｓｔｒｕｅｔｏｌｉｐｉｄ４ｈ（０．２５ｇＴＧ／ｋｇ．ｈ＾－１）第二组９例病人分别连续输注上术脂肪乳剂和葡萄糖混合液６ｈ（０．１７ｇＴＧ／ｋｇ．ｈ＾－１及０．１     

结构脂肪乳在造血干细胞移植中应用的安全性观察

目的:观察和比较结构脂肪乳(STG)和中/长链脂肪乳(MCT/LCT)的临床不良反应,以减少肠外营养(PN)并发症的发生。方法:将32例行异基因外周造血干细胞移植的血液系统肿瘤病人分为MCT/LCT组和STG组,每组各16例。分别观察病人不良反应(恶心、呕吐、头痛、发热、胸闷、心悸)和血清总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(γ-GT)、清蛋白(ALB)、肌酐(Cr)和尿素氮(UN)等指标。结果:两组病人的临床不良反应无显著性差异(P0.05)。MCT/LCT组和STG组TBil异常例数分别为2例和1例;ALT、AST异常例数分别为1例和0例。两组ALP、GGT、ALB、Cr和UN均无异常。两组病人均无肝静脉闭塞病和心脏毒性改变。结论:两种脂肪乳制剂在造血干细胞移植病人的PN治疗中安全有效,不良反应小。     

Energy expenditure in rats maintained with intravenous or intragastric infusion of total parenteral nutrition solutions containing medium- or long-chain triglyceride emulsions.

Energy expenditure was determined in male Fischer 344 rats (235-246 g) fed by intravenous (IV) or intragastric (IG) infusion with total parenteral nutrition solutions providing 65% of nonprotein energy as fat from long-chain triglyceride (LCT) or a 3:1 admixture of medium-chain triglyceride (MCT) and LCT emulsions. Respiratory gas exchange and somatomotor activity were assessed continuously for 24 h during d 5 and 11 of infusion feeding. The MCT infusion resulted in one-third the weight gain noted with LCT infusion (MCT, 10 +/- 2 g/14 d; LCT, 32 +/- 4 g/14 d; P less than 0.0001). Insulin concentration was 60% higher with IV than with IG infusion and approximately 100% higher with IV-MCT than with IG-MCT or LCT infusion (P less than 0.05). Rats receiving IV infusion of MCT displayed similar levels of motor activity but 8-13% greater daily energy expenditure (kJ.kg-0.75.kJ intake-1) than rats receiving IG-MCT or LCT infusion (P less than 0.05). The MCT infusion also resulted in an elevation in respiratory quotient after cessation of nutrient infusion (MCT, 0.87-0.92; LCT, 0.83-0.85; P less than 0.05). Total and resting energy expenditure decreased approximately 13% from 5 to 11 d of infusion feeding. The lower weight gain and greater energy expenditure seen with MCT- compared with LCT-supplemented total parenteral nutrition may be mediated by higher insulin concentrations.     

A new intravenous emulsion containing medium-chain triglyceride: studies of its metabolic effects in the perioperative period compared with a conventional long-chain triglyceride emulsion

The effects of carbohydrate, lipid, and nitrogen metabolism of recently available lipid emulsions containing either 50% medium-chain triglyceride (MCT) and 50% long-chain triglyceride (LCT) or 100% LCT were compared in elective surgical patients. Postoperative urinary urea excretion was similar during isocaloric MCT/LCT and LCT infusions (1.9 mg/kg/min) and was decreased compared with a standard infusion of 5% glucose (1 mg/kg/min). Plasma glucose and insulin concentrations were similar during both lipid and low dose glucose infusions. However, plasma triglyceride and nonesterified fatty acid concentrations were decreased during the MCT/LCT infusion compared with the LCT infusion, suggesting that the MCT/LCT emulsion was cleared from the circulation faster than pure LCT. Ketone body concentrations were similar during all three infusions. MCT/LCT emulsion can be safely infused perioperatively and has similar nitrogen conserving properties to LCT in these circumstances.     

Effects of medium-chain triglyceride in parenteral nutrition on rats undergoing gastrectomy

This study was designed to investigate the effects of pre-infusion with total parenteral nutrition (TPN) using medium-chain triglyceride (MCT) versus long-chain triglyceride (LCT) emulsion as fat sources on hepatic lipids, inflammatory mediators and antioxidant capacity in rats undergoing gastrectomy. Rats with internal jugular catheter, were divided into two groups and received TPN. TPN supplied 300 kcal/kg/d with 39% of the energy provided as fat. All TPN solutions were isonitrogenous and identical in nutrient composition except for the fat emulsion, which was composed of MCT/LCT (1 : 1) or LCT. After receiving TPN for 5 days, the rats underwent partial gastrectomy and were sacrificed 24 h after surgery. The results of the study demonstrated that the MCL/LCT group had lower hepatic lipids than did the LCT group. No differences in interleukin-1beta, interleukin-6 and tumor necrosis factor-alpha in peritoneal lavage fluid were observed between the two groups. Erythrocyte glutathione peroxidase activity was significantly higher in the LCT group than the MCT/LCT group, although erythrocyte superoxide dismutase activity did not differ significantly between the two groups. These results suggest that infusion with MCT/LCT before an abdominal operation did not have an effect on modulating the production of inflammatory mediators in the location of the injurious stimulus. However, pre-infusion with MCT/LCT have beneficial effect in improving liver lipid metabolism and reducing oxidative stress in rats with gastrectomy.     

Lipoprotein metabolism during and after a 6-h infusion ofMCT/LCT vs LCT emulsion in man

We studied, in man, the intravascular metabolism of two lipid emulsions differing in their triglyceride (TG) fatty acid pattern. One emulsion was composed exclusively of soy bean long-chain triglycerides (LCT), the other of a mixture containing a (1:1, wt:wt) ratio of medium-chain triglycerides (MCT) and LCT (MCT/LCT). Both emulsions contained 10% TG and 1.2% of the same egg yolk phospholipid emulsifier. Six healthy volunteers received both emulsions, in random order, at a rate of 0.2 g TG/kg.h for 6 h. An interval of 2 weeks separated the tests. Although the MCT/LCT emulsion provided 39% more TG molecules than the pure LCT emulsion, plasma TG increased to similar levels, indicating a faster elimination of MCT/LCT. The rise of plasma non esterified fatty acids was greater with MCT/LCT (P < 0.001). LDL-TG enrichment was higher with MCT/LCT (P < 0.025) while net transfer of TG to HDL was similar with both emulsions. Cholesteryl ester (CE) enrichment in the 'VLDL' fraction (largely composed of emulsion particles) was markedly less during MCT/LCT than LCT infusions (P < 0.01). CE enrichment of the 'VLDL' fraction persisted up to 6 h after cessation of both lipid infusions. In conclusion, TG from MCT/LCT emulsion appear to be eliminated faster than LCT during an in vivo infusion in man. In accordance with our previous in vitro data, MCT/LCT infusion was associated with a higher transfer of TG to LDL and in a reverse manner, with a lesser acquisition of CE by emulsion particles as compared to LCT infusion.     

含中链甘油三脂的脂肪乳剂有利于胃切除术后大鼠的脂类代谢和抗氧化能力

研究胃切除大鼠于术前接受以中链甘油三酯或长链甘油三酯为脂肪来源的肠外营养对肝内脂类，炎性介质和抗氧化能力的影响。大鼠经颈内静脉插管，分成两组接受肠外营养治疗。肠外营养的能量为30kcal/kg/d， 脂肪占能量的39％。除了脂肪乳剂外所有肠外营养制剂都是等氮的并含有相同的营养成分，脂肪乳剂的成分中链／长链（1：1）或长链脂肪乳剂。大鼠于接受肠外营养5天后经部分胃切除术，于术后24小时处死。研究结果显示，中逻／长链组肝内脂肪少于长链组。提示中链／长链脂肪乳剂能改善肝脏脂类代谢。两组大鼠的腹腔灌洗液（PLF）和血液中白介素－1β（Ⅱ-1β），白介素－6（Ⅱ－6）和肿瘤坏死因子α（TNF－α）无显差别，说明术前输入中链／长链脂肪乳剂对调节大鼠循环血液中的炎性介质和手术刺激没有影响。长链脂肪乳剂组的红细胞谷胱甘肽超氧化物酶（GSHPx)的活力明显高于输入中链／长链脂肪乳剂组，但红细胞超氧化物歧化酶（SOD）的活力在两组之间无显性差别。这些结果说明，腹部手术前输入中链／长链脂肪乳剂能改善脂类代谢和减少氧化物的刺激。结论：推荐对准备行胃手术的肠外营养支持的病人使用中链／长链脂肪乳剂。     

Lipid infusion with different triglyceride cores (long-chain vs medium-chain/long-chain triglycerides): effect on plasma lipids and bilirubin binding in premature infants.

The possible beneficial effects of infusing a lipid emulsion containing 50% by weight of medium-chain triglycerides (MCT) compared with a standard long-chain triglyceride (LCT) emulsion were studied in 18 premature neonates (gestational age less than 34 weeks) requiring parenteral nutrition. The infants were assigned in a double-blind manner to receive one of the two lipid emulsions over 17 hours a day as a supplemental regimen for total parenteral nutrition. A lipid load of 1 g/kg per day was initiated on the third day of life and was increased at the rate of 1 g/kg per day until a maximal dose of 3 g/kg per day was obtained on the fifth day of life and maintained thereafter. Both bound and unbound bilirubin decreased with both infusion regimens during the study period. Despite a marked increase in plasma free fatty acid levels (260% in the MCT/LCT group compared with 210% in the LCT group), the fraction of unbound (free) bilirubin was significantly lower in the MCT/LCT group (34% vs 13%). Free fatty acid levels, corrected to albumin, were positively correlated to the percentage of free bilirubin only for the LCT lipid infusion. The finding of a significant elevation of plasma cholesterol levels only in the MCT/LCT group is now under investigation. Use of the MCT-containing emulsion was not associated with a higher frequency of adverse effects than the commonly used LCT-containing emulsion.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of metabolic clearance rates of MCT/LCT and LCT emulsions in diabetics

In seven moderately overweight noninsulin-dependent diabetics with slightly elevated triglyceride levels, disappearance rates of infused medium chain triglyceride/long chain triglyceride (MCT/LCT) and long chain triglyceride (LCT) emulsions were compared. Five metabolically healthy volunteers served as controls. During a 3-hr lipid infusion, serum triglycerides reached a steady state with both emulsions in the healthy controls, whereas, in diabetic patients, steady state triglyceride levels were seen only with MCT/LCT. After the end of the lipid infusion, the longest half-life value in the decline of triglyceride levels was found with LCT in diabetics, whereas significantly shorter and quite similar half-life values were found with LCT in healthy controls and with MCT/LCT in diabetics. As expected, the shortest half-life for serum triglycerides was found in healthy controls after MCT/LCT-infusion. Virtually the same differences in serum concentrations and in half-life times were seen with free fatty acids. According to these data, if needed, parenteral nutrition with lipids in states of disturbed glucose and lipid metabolism may preferentially be done with MCT/LCT emulsions.