全胃肠外营养期间碳水化合物和脂肪摄入量对氮排泄的影响。
Effect of carbohydrate and fat intake on nitrogen excretion during total intravenous feeding.
作者信息
Long J M, Wilmore D W, Mason A D, Pruitt B A
出版信息
Ann Surg. 1977 Apr;185(4):417-22. doi: 10.1097/00000658-197704000-00008.
Abstract
Recent availability of intravenous soy bean oil emulsion for clinical trials in the United States prompted infusion of intravenous diets containing a constant nitrogen level (11.7 grams/m2/day) and 13 different combinations of carbohydrate (110-2300 kcal/m2/day) and fat (0-1100 kcal/m2/day) during 34 three-day studies in 5 patients who were clinically stable after injury or operation. Urea nitrogen excretion was inversely related to carbohydrate intake (P less than 0.01) and directly related to resting metabolic rate (P less than 0.01). Fat infusion did not affect nitrogen excretion at any level of carbohydrate intake. This study suggests that, when a primary clinical goal is nitrogen conservation, carbohydrate calories should be given in amounts approximating the resting metabolic rate. Additional calories and essential fatty acids now can be safely given as intravenous fat emulsion, but fat did not affect nitrogen conservation under the conditions of this study.
摘要
近期美国可获得静脉注射大豆油乳剂用于临床试验，这促使在5名受伤或手术后临床状况稳定的患者中开展了34项为期三天的研究，期间输注含恒定氮水平（11.7克/平方米/天）以及13种不同碳水化合物（110 - 2300千卡/平方米/天）与脂肪（0 - 1100千卡/平方米/天）组合的静脉饮食。尿素氮排泄与碳水化合物摄入量呈负相关（P < 0.01），与静息代谢率呈正相关（P < 0.01）。在任何碳水化合物摄入水平下，脂肪输注均不影响氮排泄。本研究表明，当首要临床目标是保存氮时，碳水化合物热量的给予量应接近静息代谢率。现在额外的热量和必需脂肪酸可安全地作为静脉脂肪乳剂给予，但在本研究条件下，脂肪并不影响氮的保存。
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