中链甘油三酯医用食品应用指征评价及临床应用现状调查

Current application and indications of dietary medium-chain triglycerides in hospitalized patients： an investigation and evaluation

目的 调查中链甘油三酯（MCT）膳食及其医用食品在住院患者中的应用现状,结合文献证据评价其使用指征,阐明其临床应用的合理指征把握和临床地位.方法 分析北京协和医院2012年1月至2013年12月46例次应用MCT进行膳食营养干预的住院患者情况.结果 MCT医用食品的膳食营养干预在临床实践中尚未广泛应用,但使用例次呈上升趋势,涉及消化科、儿科,呼吸科、普通内科、基本外科等13类病房.37.0％的患者存在营养不良,56.5％的患者存在低白蛋白血症.MCT干预的主要指征包括胃肠功能障碍（21例）与淋巴循环障碍（15例）,此外,血脂异常（5例）、胰腺外分泌功能不全（4例）以及难治性癫痫发作（1例）的患者也进行了MCT的营养干预.结论 目前应用MCT干预的基本临床指征与文献证据基本一致,但其目前研究证据及临床应用依然有限,期待更多高质量的大样本临床研究,指导并规范合理的营养干预.

Objective To analyze the current dietary application of medium-chain triglycerides （MCT） in hospitalized patients,and clarify the appropriate indications and the role of MCT in clinical practice through evidence-based evaluation.Method A retrospective analysis was conducted on 46 cases of hospitalized patients who were administered dietary MCT between January,2012 and December,2013 in Peking Union Medical College Hospital.Results Dietary MCT were utilized in a small but increasing number of patients,who distributed in departments of gastroenterology,pediatrics,pneumology,general internal medicine,and general surgery.37.0％ of the patients had malnutrition,while 56.5％ had hypoalbuminemia.The leading indications of MCT therapy were gastrointestinal dysfunction （21 cases） and lymph circulation disorder （15 cases）,while dyslipidemia （5 cases）,exocrine pancreatic insufficiency （4 cases）,and intractable epilepsy （1 case） served as other indications of MCT administration.Conclusions The indications of current dietary MCT application are approximately consistent with evidence from literature.However,given the scarcity of relevant researches and limited clinical application,further clinical researches with larger samples on dietary MCT are needed to provide more high-quality evidences for guidance of clinical practice.