两种脂肪乳剂对新生儿脂肪酸代谢影响的对比研究

The effects of different types of fat emulsions on fatty acids metabolism in newborn infants who experienced total parenteral nutrition

目的为研究脂肪乳剂对新生儿血清游离脂肪酸代谢的影响并指导临床合理选用脂肪乳。方法采用气相色谱法测定１８例（Ａ组１０例，Ｂ组８例）全胃肠外营养（ＴＰＮ）的新生儿血清游离脂肪酸（ＦＦＡ）谱的变化。脂肪乳剂分别选用２０％力保肪宁及２０％英特力匹特。前者含有５０％中链甘油三酯，后者只含长链甘油三酯。于ＴＰＮ前及ＴＰＮ满３天、５天取血清标本测定ＦＦＡ。结果ＴＰＮ满３天时，两组新生儿血清总脂肪酸（ＴＦＦＡ）、Ｃ１８∶０、多不饱和脂肪酸（ＰＵＦＡ）及Ｃ１８∶２均有显著升高；ＴＰＮ满５天时，Ａ组ＴＦＦＡ恢复到ＴＰＮ前的水平。ＴＰＮ满３天及５天Ｂ组ＰＵＦＡ均高于Ａ组。结论选用含５０％中链甘油三酯的脂肪乳剂代谢较快，对指导临床选用有较大的意义。

Objective To study the effects of different types of fat emulsions on fatty acids metabolism in newborn infants who experienced total parenteral nutrition (TPN). Methods Eighteen neonates were enrolled; 10 in group A received 20% Lipofundin and 8 in group B received 20% intralipid. Serum free fatty acids (FFA) were measured by gas chromatography before TPN and 3、5 days after TPN. Results After 3 days of TPN, total FFA, C 18:0 (poly unsaturate fatty acid, PUFA) and C 18:2 significantly increased in both groups. After 5 days of TPN, total FFA decreased to the pre TPN level in group A. Either at day 3 or day 5 of post TPN, PUFA in group B was constantly higher than that in group A. Conclusion 20% Lipofundin was better than 20% Intralipid in terms of the adverse effects on fatty acids metabolism.