Sheldon G F, Peterson S R, Sanders R
Arch Surg. 1978 Apr;113(4):504-8. doi: 10.1001/archsurg.1978.01370160162028.
Liver biopsy specimens were studied in 26 patients in whom liver function abnormalities developed during intravenous hyperalimentation (IVH). The clinical manifestations and duration of IVH were evaluated in relation to the morphological changes seen in the liver. Early hepatic changes consisted of fatty metamorphosis, and progressive intrahepatic cholestasis developed as IVH was continued. Essential fatty acid deficiency, amino acid imbalance, caloric excess, and toxic manifestations of certain amino acids are postulated as causative factors. The hepatic steatosis secondary to IVH may be treated by lowering the dextrose concentration of the infusion or by administering dextrose-free amino acid solutions. The clinical importance of this common complication of IVH is the difficulty in distinguishing it from other causes of cholestasis in seriously ill patients.
对26例在静脉高营养（IVH）期间出现肝功能异常的患者的肝活检标本进行了研究。评估了IVH的临床表现和持续时间与肝脏形态学变化的关系。早期肝脏变化包括脂肪变性，随着IVH的持续，逐渐出现肝内胆汁淤积。必需脂肪酸缺乏、氨基酸失衡、热量过剩以及某些氨基酸的毒性表现被认为是致病因素。IVH继发的肝脂肪变性可通过降低输注的葡萄糖浓度或给予无葡萄糖氨基酸溶液来治疗。IVH这种常见并发症的临床重要性在于，在重症患者中难以将其与其他胆汁淤积原因区分开来。
