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[低热量术后肠外营养中木糖与葡萄糖作为能量来源的比较]

[Comparison of xylose and glucose as energy sources in hypocaloric, postoperative parenteral nutrition].

作者信息

Georgieff M, Kattermann R, Geiger K, Storz L W, Bethke U, Haux P, Raute M, Barth H, Lutz H

出版信息

Infusionsther Klin Ernahr. 1981 Apr;8(2):69-76.

PMID:6785228
Abstract

After a 5 day preoperative preparing period 24 metabolically healthy patients, who had to undergo gastric resection, were fed postoperatively by hypocaloric total parenteral nutrition for a 5 day period. Group I (n = 13) received 0,11 g Xylitol/kg BW X h; Group II (n = 11) received 0,11 g Glucose/kg BW X h; Both groups received 1,71 g L-crystalline amino acids/kg BW X day. During the whole postoperative period group II had significantly higher serum Glucose and Insulin levels. Due to the high postoperative Insulin concentration in group II. Free Fatty Acids, Acetate, beta-Hydroxybutyrate and Branched Chained Amino Acids were significantly lower. The augmented release of Muscle Amino Acids and the covering of a part of the energy expenditure by increased Fatty Acid oxidation in group I led to a higher postoperative synthesis rate of visceral proteins. From postoperative day 3 on Transferrin and from postoperative day 6 on Albumin and Total Protein were significantly higher in group I. This study could demonstrate, that due to its special role in the intermediary metabolism during the postoperative period Xylitol leads to a significantly higher regeneration rate of visceral proteins compared to Glucose during total parenteral nutrition.

摘要

在为期5天的术前准备期后,24名必须接受胃切除术的代谢健康患者在术后接受了为期5天的低热量全胃肠外营养。第一组(n = 13)每千克体重每小时接受0.11 g木糖醇;第二组(n = 11)每千克体重每小时接受0.11 g葡萄糖;两组均每天每千克体重接受1.71 g L-结晶氨基酸。在整个术后期间,第二组的血清葡萄糖和胰岛素水平显著更高。由于第二组术后胰岛素浓度较高,游离脂肪酸、乙酸盐、β-羟基丁酸盐和支链氨基酸显著更低。第一组肌肉氨基酸释放增加以及通过增加脂肪酸氧化来满足部分能量消耗,导致术后内脏蛋白合成率更高。从术后第3天起转铁蛋白,以及从术后第6天起白蛋白和总蛋白,第一组显著更高。这项研究表明,在全胃肠外营养期间,由于木糖醇在术后中间代谢中的特殊作用,与葡萄糖相比,它能使内脏蛋白的再生率显著更高。

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