不同磷脂/甘油三酯比的脂肪乳剂对大鼠血脂影响

观察不同磷脂 /甘油三酯比的脂肪乳剂对血脂的影响。取大鼠随机分成三组 ,分别经上腔静脉插管输入等热量的磷脂 /甘油三酯比分别为 0 .0 6和 0 .12的脂肪乳剂 ,或不做处理。连续应用 2 4h。于实验后检测甘油三酯、磷脂、胆固醇的变化。结果 :应用脂肪乳剂后血甘油三酯两组均有提高 ,但各组间无明显差别。然而 ,与应用磷脂 /甘油三酯比为 0 .0 6的脂肪乳剂相比 ,输入磷脂 /甘油三酯比为 0 .12的脂肪乳剂后 ,血磷脂、胆固醇显著升高。结论 :磷脂 /甘油三酯比而不是甘油三酯是引起血脂蓄积的原因 ,应用低磷脂 /甘油三酯比的脂肪乳剂可减少血脂…     

30%与20%Intralipid对血脂代谢影响的研究

为观察３０％Ｉｎｔｒａｌｉｐｉｄ与２０％Ｉｎｔｒａｌｉｐｉｄ两种脂肪乳剂对血脂代谢的影响，本文以４０例外科非应激与无代谢异常病人为对象，随机分为３０％组与２０％组，分别经外周静脉予等热量的３０％Ｉｎｔｒａｌｉｐｉｄ及２０％Ｉｎ－ｔｒａｌｉｐｉｄ，连续使用３ｄ。于实验前后检测外周静脉血甘油三酯，总胆固醇，异常脂蛋白及载脂蛋白的变化。结果显示：两组研究前后血甘油三酯水平均无明显变化。２０％组血胆固醇，异常脂蛋白及载脂蛋白Ｂ水平于输注后显著升高，而３０％组则略有下降。作者认为，决定脂肪乳剂影响血脂代谢的因素并不是其甘油三酯含量而是其磷脂／甘油三酯含量比。选择具有较低磷脂／甘油三酯比的脂肪乳剂对减少高脂血症的发生有重要意义。     

脂肪乳剂对血脂代谢的影响

３０例消化道肿瘤病人随机分为３组，术后分别输注长链，中长链或低磷脂长链脂肪乳剂，观察其对血脂代谢的影响。结果示除ＬＶ，组外，ＩＬ，ＬＦ组输注后血清甘油三酯浓度显著上长，ＩＬ组血清总胆固醇浓度可见增高，ＬＦ组无明显改变，ＬＶ组则显著降低。据此，我们认为就血脂代谢而言，消化道肿瘤病人术后短期输注脂肪乳剂，以低磷脂含量者为佳；其次，在等浓度等磷脂含量脂肪乳剂中、中长链脂肪乳剂又优于单纯长链脂肪乳剂。     

不同剂量脂肪乳剂对危重早产儿血气的影响

目的：观察脂肪乳剂对危重早产儿动脉血气的影响。方法：将４０例患有肺炎等疾病的危重早产儿随机分成四组,其中１组不给予脂肪乳剂作为对照,另３组分别按每天每千克体重给予１０％Ｉｎｔｒａｌｉｐｉｄ１、２和３ｇ,连续５天。在实验前和结束时分别作血脂测定和动脉血气分析。结果：动脉血气分析示各组实验后与实验前比较无显著差异,应用脂肪乳剂１．０、２．０、３．０ｇ／（ｋｇ·ｄ）后各实验组与对照组比较差异亦不显著,仅在３．０ｇ／（ｋｇ·ｄ）组显示ＰａＯ２和ＳａＯ２有下降的趋势。血脂分析示仅在实验后３．０ｇ／（ｋｇ·ｄ）组总胆固醇比实验前显著增高,甘油三酯显著高于对照组。结论：在危重早产儿应用脂肪乳剂１～３ｇ／（ｋｇ·ｄ）对血气无显著影响,但仍提出在危重早产儿应用脂肪乳剂时仍应注意监测肺功能有关指标,如动脉血气分析。     

硒拮抗砷致大鼠血脂谱改变的效应特征研究

目的：明确硒拮抗砷致大鼠血脂谱变化的可行性及剂量特征。方法：将受试动物随机分为阴性对照组、砷组、硒组及胂＋硒组（以测试物的LD50为剂量划分依据）。染毒后测定血中血脂含量的变化。结果：与阴性对照组比较，1／5LD50As组血中总胆固醇、甘油三酯和高密度脂蛋白含量均有显著性差异（P＜0．05），总胆固醇和甘油三酯呈下降趋势，高密度脂蛋白呈上升趋势：与1／5LD50As相比，1／5LD50As＋1／160LD50Se组血中甘油三酯含量有显著性差异（P＜0．05）；1／5LD50As＋1／120LD50Se组血中总胆固醇、甘油三酯含量有显著性差异（P＜0．05）；1／5LD50As＋1／80LD50Se组血中总胆固醇、甘油三酯和高密度脂蛋白含量均有显著性差异（P＜0．05）。结论：结果提示，砷可致大鼠血脂谱的改变，硒对其具有拮抗作用，且以1／80LD50Se组拮抗效果较好。     

不同剂量外源性脂肪对危重早产儿血脂及肝功能的影响

将４０例危重早产儿随机分成４组，分别接受脂肪乳剂０、１、２、３ｇ／（ｋｇ·ｄ），连续５ｄ。结果显示，当供给脂肪乳剂１～２ｇ／（ｋｇ·ｄ）时，血脂无明显变化；３ｇ／（ｋｇ·ｄ）时，血中总胆固醇、甘油三酯明显高于对照组。血清总胆红素在各组虽有明显下降，但应用脂肪乳剂各组的血清胆红素水平均明显高于对照组，尤以３ｇ／（ｋｇ·ｄ）组最为显著，且伴有γ－ＧＴ显著升高。这一结果说明，在危重早产儿使用脂肪乳剂３ｇ／（ｋｇ·ｄ）时血脂会有明显升高；在高胆红素血症时外源性脂肪对黄疸的消退有一定的减缓作用，且随脂肪乳剂剂量增加而加强     

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。     

高脂血症模型大鼠受血脂灵片影响研究

目的：研究血脂灵片对TritonwR-1339和高脂乳剂诱导的高脂血症模型大鼠的降脂作用。方法：采用尾静脉注射Triton—WR1339（200mg／kg）诱导高脂血症大鼠模型，随机分为6组，即空白组，模型组，血脂灵片低、中、高剂量组（0．2g／kg，0．4g／kg，0．8g／kg）和辛伐他汀纽（4mg／kg），除空白组和模型组均给予相同体积的0．5％CMc—Na液，各给药组于0、3、6和9h每隔3h灌胃给药共4次，禁食12小时后，眼眶取血测试血脂水平。然后，以第一步摸索的有效剂量为依据，采用高脂乳剂（10ml／kg）诱导的高脂血症大鼠模型，各给药组灌胃给予血脂灵片30天，眼眶取血测试血脂水平。结论：血脂灵片对高脂血症大鼠具有明显的降血脂作用，并为该药降脂作用的物质基础及作用机制等的进一步实验研究奠定了基础。     

新生儿肝功能障碍时不同脂肪乳剂对血脂和肝功能影响的比较研究

目的 :比较中 /长链和长链脂肪乳剂对肝功能障碍新生儿血脂和肝功能的影响。　方法 :将 40例血清胆红素水平≥ 5 1.3μmol/L(3mg % )的新生儿随机分成两组 ,分别应用中 /长链脂肪乳剂 (MCT/LCT组 ,2 0 %Lipo fundin)和长链脂肪乳剂 (LCT组 ,2 0 %Intralipid) ,剂量均为 2 g/ (kg·d) ,持续 1周。在实验前、后分别抽血测定血脂和肝功能。　结果 :两组总胆固醇无显著变化 ,甘油三酯在LCT组升高 ,在MCT/LCT组下降 ,与实验前相比均无显著差异 ,组间比较MCT/LCT非常显著地低于LCT组。胆红素在两组均显著下降 ,但MCT/LCT组下降比LCT组更加显著。γ GT和ALP在LCT组无明显改变 ,但在MCT/LCT组却有显著降低 ,并显著低于LCT组。　结论 :在危重新生儿合并有肝功能障碍时 ,应用中 /长链脂肪乳剂显著优于长链脂肪乳剂。     

不同碳链脂肪乳剂对肝脏外科病人术后的影响

目的观察两种不同碳链脂肪乳剂对肝脏外科病人术后自然病程的影响。方法选择肝脏外科病人25例，随机分为两组；长链脂肪乳剂组（n＝12，简称LCT组），中／长链脂肪乳剂组（n=13，简称MCT组）。LCT组脂肪乳剂为20％Inralipid，MCT组为20％Lipofundin，连续观察1周。在术前，术后1、4、7天测定肝功能、血脂、血及尿液中肉毒碱（CNT）以及激素的变化。结果两组对肝脏酶学无明显影响。胆红素在术后1天明显升高，但MCT组随后显著下降，LCT组下降速度慢于MCT组，P＜0．05。PN期间血脂代谢无异常。CNT术后明显升高，尿排出减少，术后7天LCT组血CNT高于MCT组，尿CNT低于MCT组，P＜0．05。血皮质醇、胰岛素（I）、G以及G／I术后第1天均明显升高，随后逐渐下降，而LCT组术后7天，胰高糖素（G）以及G／I维持在较高水平。血糖术后明显升高，术后4、7天，LCT组持续在较高水平，MCT组已属正常。结论MCT／LCT乳剂可能是肝脏外科病人更为理想的脂肪能源。     

Comparative studies on a new concentrated fat emulsion: Intralipid 30% vs. 20%

A concentrated fat emulsion (Intralipid 30%) was tested for clinical tolerance and metabolic effects in 2 studies comparing it with Intralipid 20%. 24 healthy subjects were given 100-g fat infusions of the two emulsions over a period of 6 h on two different days in random order. At 6 h of infusion, the mean increase in the plasma triglyceride (TG) concentration was similar for the two emulsions (3.3 +/- 0.5 (SD) and 3.9 +/- 2.9 mmol/l for the 30% and 20% emulsions, respectively; NS). A significantly lower increase in plasma phospholipid (PL) concentration was noted with Intralipid 30% (0.27 +/- 0.24 vs. 0.88 +/- 0.62 mmol/l; p < 0.05). The increases in cholesterol and free fatty acid (FFA) levels were similar for the two emulsions. In another study, 20 postoperative patients were randomized to receive 100 g fat per day during 5 days as either Intralipid 30% or Intralipid 20%. Modest increases (less than 1 mmol/l) in TG, PL, FFA and cholesterol levels were noted on day 3 and one day after the completion of TPN (day 6) and there were no significant differences between the 2 groups. It is concluded that, apart from a less pronounced increase in plasma PL levels after 6 h of infusion, the metabolic effects of Intralipid 30% were similar to those observed with the 20% emulsion. The new concentrated fat emulsion was found to be clinically safe and could be considered for use in patients requiring TPN.     

Effects of a medium-chain triacylglycerol/long-chain triacylglycerol fat emulsion containing a reduced ratio of phospholipid to triacylglycerol in pediatric surgical patients

OBJECTIVE: Medium-chain triacylglycerol (MCT) has been shown to provide better nutritional support than long-chain triacylglycerol (LCT). We compared the efficacy of MCT/LCT fat emulsions containing a usual (0.12) or a decreased (0.06) ratio of phospholipid to triacylglycerol (PL:TG) in pediatric patients under surgical stress. METHODS: Three patient groups (n=10 in each) received equivalent amounts of glucose (12 g.kg(-1).d(-1)) and amino acids (2 g.kg(-1).d(-1)), but group A received a 10% MCT fat emulsion (PL:TG 0.06), group B received a 20% MCT fat emulsion (PL:TG 0.06), and group C received a 10% MCT/LCT fat emulsion (PL:TG 0.12) in amounts of 1.5 g.kg(-1).d(-1) in a randomized study. Total parenteral nutrition was given for 7 d. Blood samples were collected before total parenteral nutrition administration and on days 4 and 7 for determination of various biochemical indexes. RESULTS: Serum phospholipid concentrations were significantly higher in group C than in group A or B on days 4 and 7 (P<0.05). Serum triacylglycerol and cholesterol concentrations and the very-low-density lipoprotein percentage were also significantly higher in group C than in group A or B on days 4 and 7 (P<0.05). The high-density lipoprotein percentage was significantly higher in group B on days 4 and 7 (P<0.05). CONCLUSIONS: In pediatric patients under surgical stress, a total parenteral nutrition regimen containing an MCT/LCT fat emulsion with a decreased PL:TG ratio (0.06) is likely to result in partly better lipid and lipoprotein metabolism than an emulsion containing the usual ratio (0.12).     

Safety and metabolic tolerance of a concentrated long-chain triglyceride lipid emulsion in critically ill septic and trauma patients

BACKGROUND: A concentrated fat emulsion (Intralipid 30%) with a phospholipid/triglyceride ratio of 0.04 was tested for clinical tolerance and metabolic effects in the short-term parenteral nutrition of septic and trauma critically ill patients and compared with Intralipid 20% (phospholipid/triglyceride ratio of 0.06). METHODS: This was a prospective, randomized, multicenter study in the intensive care units in 10 university hospitals, including 90 adult patients in 2 groups: 55 septic and 35 trauma patients. Patients in each group were randomly divided into 2 subgroups according to the fat emulsions administered (1.4 g/kg per day) as part of the calories for at least 6 days of continuous total parenteral nutrition (TPN). One subgroup was treated with 30% long-chain triglycerides (phospholipid/ triglyceride ratio: 0.04) and the other with 20% long-chain triglycerides (phospholipid/triglyceride ratio: 0.06). The parenteral nutrition formula was isocaloric and isonitrogenous with 0.25 g of nitrogen/kg per day and 40% of the nonprotein calories as fat. Clinical tolerance was assessed during the study. At baseline and after 3 and 6 days of TPN, the following biochemical parameters were measured: prealbumin, retinol-binding protein, serum albumin, hematologic, hepatic and renal function variables, triglycerides, phospholipids, total and free cholesterol, nonesterified cholesterol, nonesterified fatty acids, and lipoproteins. RESULTS: At baseline, no differences in age, gender, severity of the condition [Acute Physiology and Chronic Health Evaluation (APACHE II) score], or clinical chemistry were found between the subgroups. The levels of plasma proteins studied and the renal, hematologic, or hepatic function variables did not vary during the study period. Total cholesterol increased significantly, owing to esterified cholesterol, with 20% long-chain triglyceride in septic patients (baseline: 2.1 +/- 0.8 mmol/L, day 6: 2.8 +/- 0.6 mmol/L, p = .026). In septic patients receiving 20% long-chain triglycerides, plasma triglycerides had a similar behavior (baseline: 1.4 +/- 0.6 mmol/L, day 3: 2.2 +/- 0.8 mmol/L, p < .05). The very-low-density lipoprotein content of cholesterol, triglycerides, and phospholipids showed a tendency to decrease in septic patients treated with 30% long-chain triglycerides (NS). None of the emulsions induced the synthesis of lipoprotein X. CONCLUSIONS: Our results indicate that while both fat emulsions used in the TPN of critically ill patients are clinically safe, the 30% long-chain triglyceride fat emulsion with a phospholipid/triglyceride ratio of 0.04 causes fewer lipid metabolic disturbances.     

Modification of erythrocyte membrane lipid composition induced by a single intravenous infusion of phospholipid-triacylglycerol emulsions in man

The study aimed to investigate whether, during short term infusion of lipid emulsions in man, red blood cell (RBC) membrane lipid composition was altered and RBC-free cholesterol (FC) could serve as a source of FC accumulated in the plasma. 3 normal subjects were infused intravenously with either 10% Intralipid [10% IL; PL:triglyceride (TG) weight ratio of 0.12] at the rates of 0.1, 0.2 and 0.3 g TG.kg(-1).h(-1) (providing PL intakes of 12, 24, 36 mg.kg(-1).h(-1), respectively) or with 30% Intralipid (30% IL; PL:TG ratio of 0.04) at the rate of 0.3 g TG.kg(-1).h(-1) (providing 12 mg PL.kg(-1).h(-1)). Infusion of 10% IL at a slow rate and 30% IL at a high rate caused no change in RBC and plasma FC content. However, 10% IL infusion at intermediate and high rates induced a significant decrease in RBC-FC: PL ratio. This change was still present at 18 h after the cessation of high rate infusion. RBC-FC: PL ratio and plasma PL measured during infusion were significantly correlated (r = -0.87, p < 0.001). FC efflux from RBC appears to contribute to the rise in plasma FC. This study indicates that the excessive amount of PL present as liposomes in some intravenous lipid emulsions can alter erythrocyte membrane lipid composition.     

Comparison of the elimination of 10 and 20% TRAVAMULSION lipid emulsion from the blood of beagle dogs

Metabolic utilization of fat emulsions containing 20% lipid and 10% lipid were compared using beagles. The key parameter measured was elimination of the lipid from the bloodstream, which serves as an indication of the emulsion's availability for metabolism. Nonlinear kinetic analysis was used in this determination. Blood concentrations of free fatty acids, phospholipid, and cholesterol were also measured as additional ways of determining emulsion metabolism. The 10 and 20% emulsions appeared to be equivalent in elimination of the caloric substrate triglyceride from the blood stream. Results also showed an adaptation to emulsion infusion over time at both dosages administered (3 and 6 g/kg of body weight). This was indicated by increased elimination capacity and stabilization of each lipid class measured. However, blood concentrations of phospholipid and cholesterol indicate that the 20% emulsion provides a lesser lipid load for the amount of calories administered when compared to an emulsion containing 10% lipid.     

Double-blind controlled study on the effects of dietary diacylglycerol on postprandial serum and chylomicron triacylglycerol responses in healthy humans

OBJECTIVE: The effects of dietary diacylglycerol (DG) on postprandial lipemia in healthy humans were investigated. METHODS: Forty normolipidemic male volunteers ingested fat emulsions containing either DG oil or triacylglycerol (TG) oil, at different doses: 10 g (n = 13), 20 g (n = 10) and 44 g (n = 17). Two test emulsions were given at seven-days intervals in random order. Fatty acid compositions of the test oils had been adjusted to be equal. Fasting and postprandial serum lipid concentrations in each group and plasma lipoprotein lipids in the 20 g-fat ingestion group were measured during the postprandial intervals. RESULTS: When DG emulsion was ingested, serum TG concentrations were significantly lower (p < 0.05) in the late postprandial phase, i.e., 4 hours, 6 hours as compared to the TG emulsion. The magnitude of postprandial lipemia (the area bounded by the curve above the fasting concentration) after ingestion of 44 g-DG emulsion was significantly less than that of 44 g-TG emulsion (6.54 +/- 5.12 and 8.45 +/- 7.54 mmol x h/L, mean +/- SD, respectively). Chylomicron TG, cholesterol, and phospholipid concentrations at 4 hours after ingestion of DG emulsion were significantly lower (p < 0.05) than those after the ingestion of TG emulsion at the same time point. No marked differences were observed for VLDL, LDL and HDL lipids between the test emulsions. CONCLUSION: In the usual range of fat intake (10-44 g), postprandial response after ingestion of DG emulsion was significantly less than that after ingestion of TG emulsion in healthy human subjects.     

Hypocaloric lipid emulsions and amino acid metabolism in injured rats

The present study was designed to determine the degree and mechanism by which administration of medium-chain triglyceride emulsions spare body protein after injury. Forty male rats underwent venous catheterization and received nonsterile bilateral femur fractures. All rats received 2.5 g/day amino acids and either no additional calories (group I) or 20 kcal/day of either glucose (group II), a long-chain triglyceride emulsion (group III), a medium-chain triglyceride emulsion (group IV), or a structured lipid emulsion composed of 40% sunflower oil and 60% medium-chain triglycerides (group V). The diets were administered for 3 days, and rates of plasma leucine flux, oxidation, and incorporation into protein as well as tissue protein synthetic rates in liver and muscle were measured using the constant infusion of L-[1-14C]leucine. Results demonstrated that the administration of glucose or various lipid emulsions improved cumulative nitrogen balance significantly when compared to a diet containing amino acids alone. In addition, the administration of glucose or lipid emulsions significantly stimulated protein synthesis in liver and muscle. Moreover, a structured lipid emulsion of medium- and long-chain fatty acids produced significant increases in liver protein synthesis greater than that observed with either glucose or long-chain triglyceride emulsions. We conclude that added energy as fat or glucose reduces net protein catabolism and improves tissue protein synthesis in these injures rats and that lipid emulsions are as effective as dextrose. A structured triglyceride emulsion synthesized from medium- and long-chain fatty acids appears to better support hepatic protein synthesis.     

Alteration of erythrocyte lipid composition following total parenteral nutrition in the rat

Rats were infused continuously for 7 days with a complete total parenteral nutrition (TPN) solution in which 27.5% total calories were given as a parenteral lipid emulsion containing soybean oil (Liposyn) or safflower oil (Intralipid) emulsified with egg phospholipid (PL). Compared to sham-operated rats fed chow, the erythrocyte membranes from rats given TPN with lipid emulsion had increased cholesterol and PL but normal molar cholesterol:PL ratios. The fatty acid changes in sphingomyelin and phosphatidylcholine, in particular, suggested replacement of endogenous PL with the exogenous egg PL infused with the emulsion. The changes in membrane lipid composition were accompanied by greater resistance of the cells from rats given TPN to osmotic lysis in vitro.     

Lymph chylomicron composition and size are modified by level of intestinally infused cholesterol and triglyceride source in rats.

Mesenteric lymph chylomicrons were characterized following acute continuous intestinal infusion of triglyceride emulsions in rats. Emulsions were prepared using corn, olive or butter oils with graded doses of cholesterol (0, 3, 10, 20, 30, 60, 100 mg/g triglyceride) added to each. Chylomicron cholesterol content varied directly with dose of cholesterol infused, ranging from approximately 1.5% (by weight) with no added cholesterol to 5-10% at 100 mg cholesterol/g triglyceride. Minimum effective dose for increasing chylomicron cholesterol content (about twofold) was 20 mg/g triglyceride regardless of the triglyceride source. Esterified cholesterol accounted for most of the increase in chylomicron total cholesterol with corn oil infusion, whereas increases in the unesterified fraction accounted for 10-30% of the increase in total cholesterol during infusion of olive or butter oils. The effect of infused cholesterol on chylomicron lipid composition was dependent on triglyceride source: no effect on phospholipid:triglyceride ratio with corn and butter oils, but increased phospholipid:triglyceride ratio with olive oil at cholesterol doses greater than 20 mg/g triglyceride. Infusion of butter emulsions produced smaller chylomicrons than those produced during infusion of corn or olive oil emulsions.