Bässler K H
Infusionsther Klin Ernahr. 1976 Aug;3(4):198-200.
The interactions of fat and carbohydrate metabolism are surveyed. The posttraumatic metabolism is characterized by a stress induced high lipolytic rate and a high concentration of non-esterified fatty acids in the blood. The increased fatty acid oxidation causes by effects of metabolites a catabolic situation with enhanced ketogenesis, gluconeogenesis and protein breakdown. High levels of fatty acids and ketone bodies reduce peripheral glucose utilization. In such a situation, infusions of fat emulsions are disadvantageous, since fatty acids, set free from the triglycerides, would aggravate the catabolic metabolism and change the nitrogen balance for the worse. In normal metabolic situations with high energy need, or in long term parenteral nutrition, fat infusions are necessary to meet the needs of energy and of essential fatty acids. Fat infusions shoudl be combined with carbohydrates and amino acids in an appropriate relation.
本文综述了脂肪与碳水化合物代谢的相互作用。创伤后代谢的特点是应激诱导的高脂解率和血液中非酯化脂肪酸的高浓度。脂肪酸氧化增加通过代谢产物的作用导致分解代谢状态，伴有酮生成、糖异生和蛋白质分解增强。高水平的脂肪酸和酮体会降低外周葡萄糖利用率。在这种情况下，输注脂肪乳剂是不利的，因为从甘油三酯中释放出来的脂肪酸会加重分解代谢，并使氮平衡恶化。在能量需求高的正常代谢情况下，或在长期肠外营养中，输注脂肪对于满足能量和必需脂肪酸的需求是必要的。脂肪输注应与碳水化合物和氨基酸以适当的比例联合使用。
