早产儿应用脂肪乳剂的安全性研究

Safety of fats emulsion administration in preterm infants

目的评价２０％英脱利匹特（ｉｎｔｒａｌｉｐｉｄ）在早产儿应用中的安全性。方法４６例早产儿随机分为４组：治疗组分别于生后第１天（Ａ组，１１例）和第３天（Ｂ组，１２例）经外周静脉按０１５ｇ／（ｋｇ·ｈ）输入０５～３５ｇ／（ｋｇ·ｄ）脂肪乳剂１周；Ｃ（１１例）、Ｄ（１２例）组（不用脂肪乳剂）分别与Ａ、Ｂ组对照，并于实验前后监测血气、血生化、脂肪酸生化指标和血糖的变化。结果生后第１，３天治疗组和对照组动脉血氧分压、氧饱和度、胆红素、丙氨酸转氨酶、过氧化脂质、６－酮－前列腺素Ｆ１α、血栓素Ｂ２及血糖浓度差异均无显著性意义（Ｐ均＞００５）。结论自生后第１天或第３天即开始经外周静脉按０１５ｇ／（ｋｇ·ｈ）速率，逐渐增加剂量，从第１天０５ｇ／（ｋｇ·ｄ），每天增加１ｇ／（ｋｇ·ｄ），至最大量３５ｇ／（ｋｇ·ｄ）。

Objective To investigate the potential risk for intravenous fats emulsion administration in preterm infants who require partial parenteral nutrition.Methods 64 preterm infants with birth weight<2500g were randomly divided into 4 groups:treated group A( n =11) and B( n =12),receiving intravenously 20% intralipid on the first day and the third day of life,respectively;group C( n =11) and D( n =12),as corresponding controls of group A and B.Treated infants were given 20% intralipid 0 5g/(kg·d) on the first day to 3 5g/(kg·d) by the day 4～7.Blood gas,blood glucose,total albumin ,bilirubin,alanine aminotransferase,serum triglycerides and cholesterol,thromboxin B 2(TXB 2),6-keto-prostaglandin F 1α (6-keto-PGF 1α ),lipid peroxides were determined before and after the experiment.Results There were no significant differences between experimental groups and control groups in artery blood oxygen partial pressure,oxygen saturation,bilirubin,alanine aminotransferase(ALT),lipid peroxides,6-keto-PGF 1α ,TXB 2 and blood glucose(all P >0 05).Conclusion It is relatively safe to apply 20% intralipid intravenously to preterm infants(on the first or third day of life) who require partial parenteral nutrition with a definitive dose and infusion rate for a week.