Jiang Weiwei, Chen GuangLin, Zhang Jie, Lv Xiaofeng, Lu Changgui, Chen Huan, Li Wei, Li Hongxing, Geng Qiming, Xu Xiaoqun, Tang Weibing
Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
Pediatr Surg Int. 2019 Mar;35(3):347-355. doi: 10.1007/s00383-018-4422-2. Epub 2018 Nov 24.
There are many advantages of a SMOF emulsion (SMOF-lipid), such as liver-protective properties and anti-inflammatory effects. The objective of this study was to compare the clinical outcomes of SMOF-lipid with medium-chain triglycerides (MCT) /long-chain triglycerides (LCT) in infants after intestinal surgery.
This was a prospective, randomized study. Neonates receiving intravenous nutrient solution, including lipid emulsion after gastrointestinal surgery, were included in this study. The patients were randomly assigned to the SMOF-lipid or MCT/LCT groups. Infants who received intravenous lipid emulsion continuously for > 2 weeks were considered to have completed the study. Differences in weight gain, nutrition indices, alanine transaminase (ALT), aspartate transaminase (AST), and direct bilirubin (DB), and inflammation cytokine markers (interleukin [IL]-6 and tumor necrosis factor [TNF]-α) were measured.
The final sample included 160 infants. One hundred fourteen infants received intravenous SMOF-lipid (74) or MCT/LCT (86) > 2 weeks and 46 infants received intravenous SMOF-lipid (22) or MCT/LCT (24) > 4 weeks. There were no significant differences in weight gain, nutrition indices, inflammation cytokine markers, and sepsis between the groups at the end of 2 and 4 weeks; however, in the SMOF group, the ALT, AST, and DB levels were significantly lower than the MCT/LCT group at the end of 4 weeks.
The mixture and balanced emulsion of SMOF-lipid was well-tolerated in infants who have undergone gastrointestinal surgery, and liver-protective properties were demonstrated following long-term venous nutrition, especially > 4 weeks.
结构中/长链脂肪乳剂（SMOF-脂质）具有许多优点，如肝脏保护特性和抗炎作用。本研究的目的是比较SMOF-脂质与中链甘油三酯（MCT）/长链甘油三酯（LCT）在婴儿肠道手术后的临床结局。
这是一项前瞻性随机研究。本研究纳入接受静脉营养液（包括胃肠道手术后的脂质乳剂）的新生儿。患者被随机分配至SMOF-脂质组或MCT/LCT组。持续接受静脉脂质乳剂治疗>2周的婴儿被视为完成研究。测量体重增加、营养指标、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、直接胆红素（DB）以及炎症细胞因子标志物（白细胞介素[IL]-6和肿瘤坏死因子[TNF]-α）的差异。
最终样本包括160名婴儿。114名婴儿接受静脉SMOF-脂质（74名）或MCT/LCT（86名）治疗>2周，46名婴儿接受静脉SMOF-脂质（22名）或MCT/LCT（24名）治疗>4周。在2周和4周结束时，两组之间在体重增加、营养指标、炎症细胞因子标志物和败血症方面无显著差异；然而，在4周结束时，SMOF组的ALT、AST和DB水平显著低于MCT/LCT组。
SMOF-脂质的混合平衡乳剂在接受胃肠道手术的婴儿中耐受性良好，长期静脉营养（尤其是>4周）后显示出肝脏保护特性。
