降低葡萄糖含量预防全肠外营养所致淤胆的作用

The effrct of reduced glucose content on prevention of TPN-induced cholestasis

作者将39例使用低热量、低葡萄糖 TPN 患者的 AKP,I-GT,TBil,ALT,白蛋白、氮平衡与30例使用高热量、高葡萄糖 TPN 患者的相应值进行了比较。结果发现,使用低热量、低葡萄糖 TPN 可延缓和减轻临床长期使用 TPN 患者的 AKP,I-GT,TBil,ALT 异常的发生。作者提出,在临床长期使用 TPN 时,应注意非蛋白质热量,葡萄糖、脂肪的给量,以热量30kcal·kg^(-1)/d(125.4kJ·kg(-1)/d),葡萄糖≤5g·kg(-1)/d,脂肪≤2g·kg(-1)/d,糖脂比6∶4,热氮比150kcal∶1(627kJ∶1)为佳;AKP,I-GT,TBil,ALT 联合应用可作为 TAN 所致淤胆的观察指标。

AKP,r-GT,TBil,ALT,albumin and nitrogen balance of 39 patients who received lower calorie and less glucose content TPN were compared to 30 patients supported with higher calorie and more glucose parenteral nutrition.The results showed that lower calorie and less glucose content TPN supported patients had a delayed and less elevated serum AKP,r-GT,TBil,ALT.We suggested that a TPN regimen containing nonprotein calorie at a level of 30kcal·kg^(-1)/d (125.4kJ·kg^(-1)/ d),glucose≤5g·kg^(-1)/d,fat≤2g·kg^(-1)/d,G/F equal 5/4 with a calorie/nitrogen ratio of 150kcal:1g(627kJ·1g) is suitable for patients who need a longer time TPN-support.Serum levels of AKP,γ-GT,TBil,ALT could be used to monitor index for detecting TPN induced cholestasis.