长期肠外营养新生儿血浆肉碱水平分析

Plasma carnitine levels in neonates receiving long-term total parenteral nutrition

目的了解长期全肠外营养的足月新生儿血浆肉碱浓度变化和相关的代谢改变。方法需全肠外营养支持的新生儿12例(男4例,女8例),采用同一肠外营养方案,于肠外营养支持第1天和最后1天测定血浆肉碱、肝功能和血脂水平。结果最后1天与第1天比较血浆肉碱的浓度明显下降(293μmol/L 对32.2μmol/L,P=0.021);肝功能中 ALT、AKP 显著上升(ALT:22.8 IU/L 对12.3 IU/L,P=0.020;AKP:191.5μmol/L 对125.5μmol/L,P=0.043);血甘油三酯明显上升(1.17 mmol/L 对0.65 mmol/L,P=0.035)。结论长期接受不含肉碱的全肠外营养将影响血浆肉碱的浓度,导致血脂和肝功能变化。[临床儿科杂志,2008,26(10):872-874]

Objectives To investigate the plasma carnitine concentration in term neonates receiving long-term total parenteral nutrition, and to detect the relative metabolic changes. Methods Twelve neonates （4 boys and 8 girls） were recruited and administrated the same parenteral nutrition formula. The plasma carnitine, liver function and blood fat were determined at the beginning and the last day of total parenteral nutrition period. Results The plasma carnitine concentration decreased significantly （32.2 μmol/L vs 29.3 μmol/L, P = 0.021）. ALT and AKP increased （ALT： 12.3 IU/L vs 22.8 IU/L, P = 0.020; AKP： 125.5 μmol/L vs 191.5 μmol/L, P = 0.043）. The triglyceride concentration also increased significantly （0.65 mmol/L vs 1.17 mmol/L, P = 0.035）. Conclusions Long-term total parenteral nutrition without carnitine would interfere with the plasma eamitine concentration and induce the changes of blood fat and liver function consequently.