Ma Zheng-Wei, Liu Li-Dong, Li Kun, Zhang Yu-Jun, Dong Jia-Hong
Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan, Shapingba, Chongqing 400038, PR China.
Colloids Surf B Biointerfaces. 2007 Jan 15;54(1):25-32. doi: 10.1016/j.colsurfb.2006.05.017. Epub 2006 Jun 2.
Nutritional supports are required for liver transplant patients. However, no systematical assessment has been made of the optimal composition of energy yielding substrates in these patients. This study is to evaluate whether mixed energy system consisting of carbohydrate and lipid emulsions is more advantageous over single energy source of glucose for nutritional support in liver transplant recipients and whether structured lipid emulsion (STG) is superior to medium-chain triglyceride/long-chain triglycerides (MCT/LCT) and long-chain triglycerides (LCT) using a total parenteral nutrition model. Liver transplant rats were randomly divided to four groups according to the energy source, i.e. glucose (GLU), MCT/LCT, STG and LCT groups. Sham operated rats served as control. Hepatic function and lipid profile were determined to investigate the roles of lipid emulsion in hepatic function and lipid metabolism. Morphological changes of liver were observed, and nitrogen balance was determined. The results showed that infusion of lipid emulsion was well tolerated. The 1-week survival rate in the lipid emulsion groups was significantly higher than in the GLU group (100% versus 50%, P<0.05); compared with the GLU group, hepatic function recovered quickly and returned to normal level, and morphological alterations were less severer in the lipid emulsion groups, especially in the STG group; the lipid emulsions groups had normal serum TG and TC levels, especially STG and MCT/LCT groups; the lipid emulsions groups achieved a positive nitrogen balance on day 7 compared with the GLU group, and the STG group had the highest nitrogen balance. In conclusion, lipid emulsion is beneficial in improving hepatic function and the recipients' survival and does not influence the lipid metabolism. Mixed energy system consisting of carbohydrate and lipid is more advantageous over single energy source of glucose after liver transplantation, and STG is superior to MCT/LCT and LCT.
肝移植患者需要营养支持。然而，尚未对这些患者中产生能量的底物的最佳组成进行系统评估。本研究旨在评估由碳水化合物和脂质乳剂组成的混合能量系统在肝移植受者营养支持方面是否比单一葡萄糖能量来源更具优势，以及使用全胃肠外营养模型时，结构脂质乳剂（STG）是否优于中链甘油三酯/长链甘油三酯（MCT/LCT）和长链甘油三酯（LCT）。肝移植大鼠根据能量来源随机分为四组，即葡萄糖（GLU）组、MCT/LCT组、STG组和LCT组。假手术大鼠作为对照。测定肝功能和血脂谱以研究脂质乳剂在肝功能和脂质代谢中的作用。观察肝脏的形态学变化，并测定氮平衡。结果表明，脂质乳剂的输注耐受性良好。脂质乳剂组的1周生存率显著高于GLU组（100%对50%，P<0.05）；与GLU组相比，脂质乳剂组肝功能恢复迅速并恢复至正常水平，形态学改变较轻，尤其是STG组；脂质乳剂组血清TG和TC水平正常，尤其是STG组和MCT/LCT组；与GLU组相比，脂质乳剂组在第7天实现了正氮平衡，且STG组的氮平衡最高。总之，脂质乳剂有利于改善肝功能和受者的生存率，且不影响脂质代谢。肝移植后，由碳水化合物和脂质组成的混合能量系统比单一葡萄糖能量来源更具优势，且STG优于MCT/LCT和LCT。
