Druml W, Fischer M, Pidlich J, Lenz K
Medical Department III, Vienna General Hospital, Austria.
Am J Clin Nutr. 1995 Apr;61(4):812-7. doi: 10.1093/ajcn/61.4.812.
Elimination and hydrolysis of fat emulsions containing long-chain (LCT) or long- and medium-chain triglycerides (MCT, 50:50) were compared in eight patients with advanced chronic hepatic failure (CHF) and six healthy control subjects by using a two-stage constant infusion protocol. In control subjects clearance of MCT was slightly higher than that of LCT (1.93 +/- 0.34 vs 1.55 +/- 0.3 mL.kg-1.min-1, P < 0.05). The rise in plasma triglycerides was similar and the release of free fatty acids was higher during MCT (P < 0.02). In CHF patients, clearance of both LCT and MCT was comparable with that in healthy subjects and the rise in plasma triglycerides and release of free fatty acids was identical. We conclude that a clinically relevant infusion rates the elimination of lipid emulsions containing LCT or LCT and MCT and the release of free fatty acids thereof is not altered in patients with CHF and that intravenous lipids are a suitable source of energy and essential fatty acids (and phospholipids) for parenteral nutrition.
通过两阶段持续输注方案，比较了8例晚期慢性肝衰竭（CHF）患者和6名健康对照者对含长链（LCT）或长链与中链甘油三酯（MCT，50:50）的脂肪乳剂的清除及水解情况。在对照者中，MCT的清除率略高于LCT（1.93±0.34对1.55±0.3 mL·kg⁻¹·min⁻¹，P<0.05）。血浆甘油三酯的升高相似，而MCT输注期间游离脂肪酸的释放更高（P<0.02）。在CHF患者中，LCT和MCT的清除率与健康受试者相当，血浆甘油三酯的升高和游离脂肪酸的释放相同。我们得出结论，在临床相关输注速率下，CHF患者对含LCT或LCT与MCT的脂质乳剂的清除及其游离脂肪酸的释放未改变，并且静脉内脂质是肠外营养的合适能量和必需脂肪酸（及磷脂）来源。
