蔗糖铁及右旋糖酐铁对儿科静脉营养液中脂肪乳剂稳定性的影响

Effects of iron dextran or iron sucrose on the stability of fat emulsion in total nutrient admixtures for pediatric patients

目的 分析静脉营养液中分别加入两种不同铁剂（蔗糖铁及右旋糖酐铁）后对脂肪乳剂稳定性的影响。方法 按静脉营养配制操作规范加入两种不同剂量铁剂（分别为蔗糖铁及右旋糖酐铁）的静脉营养液各10袋,肉眼观察含不同当量铁剂（0.25、0.50、0.75和1.00 mg ）的静脉营养液在室温（25 ℃）悬挂静置3 d，扫描电镜观察3 d内的脂肪颗粒平均大小、直径＞0.5 μm百分比、营养混合液的pH值及渗透浓度。结果 含不同铁剂的营养液在不同时间点的脂肪颗粒大小差异无统计学性意义（F=0.32，P=0.7836；F=1.73，P=0.1321）。72 h内各组脂肪乳颗粒平均大小均＜0.5 μm，并且均未见到直径＞5 μm的脂肪颗粒，含不同浓度铁的TNA在不同时间点间脂肪颗粒＞0.5 μm的百分比、pH值及渗透压差异均无统计学意义 （百分比：F=1.47，P=0.3467；F=1.04，P=0.4758。pH值：F=0.63，P=0.5942；F=0.46，P=0.6825。渗透压：F=1.37，P=0.3648；F=0.65，P=0.6023）。结论 浓度小于1%蔗糖铁及右旋糖酐铁分别加入儿科静脉营养液是稳定的。

Objective To evaluate the effects of iron dextran or iron sucrose on the stability of fat emulsion in total nutrient admixture （TNA） in pediatric settings. Methods TNA with different intravenous doses of iron sucrose or iron dextran （0.25, 0.5, 0.75, or 1.00 mg） were prepared, and each dose was prepared 10 bags. The TNAs were stored at 25 ℃ for 3 days, and the stability of fat emulsion was observed by electron scanning microscopy. Meanwhile, the pH and osmolality were also measured. Results The particle sizes of fat emulsions in TNA with different concentrations of iron sucrose or iron dextran at different time points were not significantly different （F=0.32,P=0.7836;F=1.73,P=0.1321, respectively）. The mean particle size of the fat emulsion in each group was 〈0.5 μm within 72 hours. For TNA containing different concentrations of iron, the percentage of particles〉 0.5 μm, pH, and osmotic pressure showed no significant difference at different time points （percentage： F=1.47,P=0.3467;F=1.04,P=0.4758. pH： F=0.63,P=0.5942;F=0.46,P=0.6825.osmotic pressure：F=1.37,P=0.3648;F=0.65,P=0.6023）. ConclusionThe TNA addeded with iron sucrose or iron dextran with an concentrations of 〈1% is stable.