Li Rongrong, Ma Jiangfeng, Yu Kang, Wang Lilin
Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Endocrinology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Asia Pac J Clin Nutr. 2015;24(3):387-93. doi: 10.6133/apjcn.2015.24.3.18.
Medium chain triglycerides (MCTs) are of nutritional interest for their unique properties on ingestion, absorption and metabolism. However, dietary and enteral MCTs usage in hospitalized patients in China requires evaluation.
A retrospective analysis was conducted on 46 hospitalized patients who were administered MCTs therapy between January, 2012 and December, 2013 in Peking Union Medical College Hospital. The clinical parameters of subjects were evaluated 2 weeks after intervention. All indications and outcomes of MCTs therapy underwent evidence-based evaluation. A survey was conducted on a random sample of 77 doctors to clarify the awareness and knowledge of MCTs therapy among clinicians.
Among 46 cases undergoing MCTs therapy, there were 21 with gastrointestinal dysfunction (with improvement in 15 cases), 15 with lymphatic anomalies (with improvement in 7 cases), 5 with dyslipidemia (with improvement in 3 cases), 4 with exocrine pancreatic insufficiency (with improvement in 2 cases) and 1 with epilepsy (without improvement). All indications were evidence -based. Although MCTs were being utilized in an increasing number of patients, the survey revealed poor knowledge of their physicochemical properties, medical indications and the therapeutic basis of their use among clinicians.
MCTs therapy is of benefit in the management of gastrointestinal malabsorption, pancreatic exocrine insufficiency, intestinal lymphangiectasia and dyslipidemia. However, randomized controlled trials with adequate sample size and longer follow-up are required to evaluate further their efficacy, and more educational programs are needed to ensure clinical competence for MCT therapy.
中链甘油三酯（MCTs）因其在摄入、吸收和代谢方面的独特性质而具有营养研究价值。然而，在中国住院患者中，饮食及肠内使用MCTs的情况需要评估。
对2012年1月至2013年12月在北京协和医院接受MCTs治疗的46例住院患者进行回顾性分析。干预2周后评估受试者的临床参数。对MCTs治疗的所有适应症及结果进行循证评估。对77名医生进行随机抽样调查，以明确临床医生对MCTs治疗的认知和了解情况。
在接受MCTs治疗的46例患者中，21例患有胃肠功能障碍（15例有所改善），15例患有淋巴异常（7例有所改善），5例患有血脂异常（3例有所改善），4例患有外分泌性胰腺功能不全（2例有所改善），1例患有癫痫（无改善）。所有适应症均有循证依据。尽管使用MCTs的患者数量在增加，但调查显示临床医生对其理化性质、医学适应症及使用的治疗依据了解不足。
MCTs治疗在胃肠吸收不良、胰腺外分泌功能不全、肠淋巴管扩张和血脂异常的管理中有益。然而，需要进行样本量充足且随访时间更长的随机对照试验来进一步评估其疗效，还需要更多的教育项目以确保临床医生具备MCT治疗的能力。
