Elwyn D H, Kinney J M, Gump F E, Askanazi J, Rosenbaum S H, Carpentier Y A
Metabolism. 1980 Feb;29(2):125-32. doi: 10.1016/0026-0495(80)90136-5.
Severely depleted surgical patients were given total parenteral nutrition, providing an average of 34.6 kcal and 266 mg nitrogen/kg body weight. Two diets were used, one with glucose as sole source of nonprotein energy, the other with a fat emulsion, Liposyn 10%, substituted isocalorically for one-third of the glucose. The two diets were given alternately, for 1 wk at a time, to each patient. N balance, at zero energy balance, was estimated to average 50 mg nitrogen/kg, indicating that energy intake in excess of expenditure is not required to restore lean body mass in depleted patients. Nitrogen (N) balance was equally good with either diet. Respiratory quotients and carbohydrate oxidation were lower, and fat oxidation was higher with the fat-containing diet. Amino acids and glucose were infused continuously over each 24-hr period and fat was given for only 6--8 hr. During the period of fat infusion, fat oxidation was significantly higher, and carbohydrate oxidation and RQ were lower than at other times of day.
严重营养不良的外科手术患者接受了全胃肠外营养，平均每千克体重提供34.6千卡热量和266毫克氮。使用了两种饮食方案，一种以葡萄糖作为非蛋白质能量的唯一来源，另一种用脂肪乳剂（10%的Liposyn）等热量替代三分之一的葡萄糖。两种饮食方案交替给予每位患者，每次为期1周。在能量平衡为零的情况下，氮平衡估计平均为每千克体重50毫克氮，这表明在营养不良的患者中，恢复瘦体重并不需要能量摄入超过消耗。两种饮食方案的氮平衡同样良好。含脂肪饮食的呼吸商和碳水化合物氧化较低，脂肪氧化较高。氨基酸和葡萄糖在每24小时内持续输注，脂肪仅输注6 - 8小时。在脂肪输注期间，脂肪氧化显著高于其他时段，碳水化合物氧化和呼吸商则低于其他时段。
