输入不同链长的脂肪乳剂后血中酮体的动态观察

应用酶促法研究了输入不同链长的脂肪乳剂后病人血中酮体的变化。其中第一组8例病人接受输入剂量为0.14g/kg.h的中链或长链脂肪乳剂的廓清实验,第二组的12例病人在肠外营养(total parenteral nutrition,TPN)接受输入剂量为0.06g/kg.h的中链或长链的脂肪乳剂。而且还测定了30例正常人(男女各15例)血清β-羟丁酸的含量。研究结果,表明中链脂肪乳剂在廓清剂量时,血中酮体高于正常水平,而在常规胃肠外营养支持时,中链脂肪乳剂或长链脂肪乳剂均无血酮体升高现象,在临床上应用是安全的。

The Kinetic Observation of Serum Ketone Body Levels in Surgical Patients Receiving MCT or LCT Emulsions

The changes of serum beta-hydroxybutyrate concentrations in patients after receiving medium chain triglycerides (MCT) or long chain triglycerides (LCT) were studied. The patients were divided into two groups: in Group 1, the dose of fat was 0.14 g/kg.h for fat emulsion clearance test: and in Group 2, the dose was 0.06 g/kg.h for total parenteral nutrition (TPN) support. The beta-hydroxybutyrate concentrations were estimated by an enzymatic method using Sigma's beta-hydroxybutyrate kit (Sigma Diagnostics, MO 63178, USA). The normal range of beta-hydroxybutyrate concentration in 30 healthy Chinese subjects was 1.04 +/- 1.42 mg/dl (range 0-3.88 mg/dl). In Group 1, we found that the concentrations of beta-hydroxybutyrate rose steadily after fat emulsion infusion. The concentrations in the medium chain triglyceride group were higher than those in long chain triglyceride group. The elevated concentrations of beta-hydroxybutyrate gradually returned to normal levels when the emulsion infusion was stopped. In Group 2, the concentrations of beta-hydroxybutyrate in the patients were within the normal range.