Abushufa R, Reed P, Weinkove C, Wales S, Shaffer J
Department of Medicine, Hope Hospital, Salford, United Kingdom.
JPEN J Parenter Enteral Nutr. 1995 Jul-Aug;19(4):286-90. doi: 10.1177/0148607195019004286.
Patients on total parenteral nutrition are known to be at risk of the development of essential fatty acid deficiency, presenting as a syndrome with scaly skin lesions and characterized by low plasma and erythrocyte linoleic acid concentrations. The essential fatty acid status of patients on long-term home parenteral nutrition who do have access to oral feeds has not been studied.
With the use of an isocratic high-performance liquid chromatography method, fatty acids were measured in the erythrocytes and plasma of 25 nonfasting patients on long-term home parenteral nutrition and the findings compared with those of 46 hospital outpatients not on nutrition support and five laboratory staff.
Statistically significant differences in the two groups were limited to the erythrocytes. Linoleic acid was significantly lower (25.2 vs 40.7 mumol/10(6) red blood cells, p < .0001) and showed a significant correlation with triceps skinfold thickness (r = .52, p = .013). Palmitoleic and oleic acids were higher in patients than controls (10.8 vs 8.4 mumol/10(6) red blood cells, p = .009; 61.2 vs 51.7 mumol/10(6) red blood cells, p = .003).
Despite IV linoleic acid administration, patients on long-term home parenteral nutrition have low erythrocyte stores of this essential fatty acid. This appears to be related to their low body fat stores. We suggest that they may be using much of the infused linoleic acid as an energy source and therefore are at risk of subclinical essential fatty acid deficiency.
已知接受全胃肠外营养的患者有发生必需脂肪酸缺乏的风险，表现为一种伴有皮肤鳞屑性病变的综合征，其特征为血浆和红细胞亚油酸浓度降低。对于有口服进食机会的长期家庭肠外营养患者的必需脂肪酸状况尚未进行研究。
采用等度高效液相色谱法，对25例非禁食的长期家庭肠外营养患者的红细胞和血浆中的脂肪酸进行测定，并将结果与46例未接受营养支持的医院门诊患者及5名实验室工作人员的结果进行比较。
两组间具有统计学意义的差异仅限于红细胞。亚油酸显著降低（25.2对40.7μmol/10⁶个红细胞，p<0.0001），并且与肱三头肌皮褶厚度呈显著相关（r = 0.52，p = 0.013）。患者的棕榈油酸和油酸高于对照组（10.8对8.4μmol/10⁶个红细胞，p = 0.009；61.2对51.7μmol/10⁶个红细胞，p = 0.003）。
尽管给予了静脉亚油酸，但长期家庭肠外营养患者的这种必需脂肪酸的红细胞储备仍较低。这似乎与他们较低的体脂储备有关。我们认为他们可能将大量输注的亚油酸用作能量来源，因此有亚临床必需脂肪酸缺乏的风险。
