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除肠外营养加脂肪乳剂外,静脉注射肉碱可能会减轻术后外科患者的炎症反应。

Intravenous Carnitine Administration in Addition to Parenteral Nutrition With Lipid Emulsion May Decrease the Inflammatory Reaction in Postoperative Surgical Patients.

作者信息

Koyama Yu, Moro Kazuki, Nakano Masato, Miura Kohei, Nagahashi Masayuki, Kosugi Shin-Ichi, Tsuchida Junko, Ikarashi Mayuko, Nakajima Masato, Ichikawa Hiroshi, Hanyu Takaaki, Shimada Yoshifumi, Sakata Jun, Kameyama Hitoshi, Kobayashi Takashi, Wakai Toshifumi

机构信息

Department of Nursing, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi, Niigata, Niigata 951-8518, Japan.

Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

J Clin Med Res. 2017 Oct;9(10):831-837. doi: 10.14740/jocmr3113w. Epub 2017 Sep 1.

Abstract

BACKGROUND

A prospective randomized study was performed to investigate the validity of intravenous carnitine administration during postoperative parenteral nutrition (PN) with lipid emulsion.

METHODS

Patients undergoing surgery for gastric or colorectal cancer were enrolled in the study and were randomly divided into two groups (n = 8 in each group): 1) group L, who received a peripheral PN (PPN) solution of 7.5% glucose, 30% amino acid, and 20% lipid emulsion; and 2) group LC, who received the same PPN solution, as well as carnitine intravenously. PPN was performed from postoperative day (POD) 1 to POD4. Clinical and laboratory parameters were compared between the two groups; statistical significance was set at P < 0.05.

RESULTS

Serum carnitine concentrations were significantly higher in group LC on POD3 (P < 0.01) and POD7 (P = 0.01). Postoperative changes in laboratory parameters and morbidity were comparable between the two groups. However, the decrease in C-reactive protein from POD3 to POD7 was significantly greater in group LC than in group L (P = 0.011).

CONCLUSION

The results show that intravenous carnitine administration in addition to PN is safe and may be beneficial for recovery from postoperative inflammatory reactions.

摘要

背景

进行了一项前瞻性随机研究,以调查术后肠外营养(PN)期间静脉给予肉碱与脂质乳剂联合应用的有效性。

方法

纳入接受胃癌或结直肠癌手术的患者并随机分为两组(每组n = 8):1)L组,接受含7.5%葡萄糖、30%氨基酸和20%脂质乳剂的外周肠外营养(PPN)溶液;2)LC组,接受相同的PPN溶液,并静脉给予肉碱。PPN从术后第1天(POD)至POD4进行。比较两组的临床和实验室参数;设定P < 0.05为具有统计学意义。

结果

LC组在POD3(P < 0.01)和POD7(P = 0.01)时血清肉碱浓度显著更高。两组间实验室参数的术后变化和发病率相当。然而,LC组从POD3至POD7时C反应蛋白的下降幅度显著大于L组(P = 0.011)。

结论

结果表明,除PN外静脉给予肉碱是安全的,可能有利于从术后炎症反应中恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf02/5593430/c15c9ceda73f/jocmr-09-831-g001.jpg

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