静脉输注脂肪乳注射液（C14-24）致高龄患者脂肪超载综合征

Fat overload syndrome in an elderly patient caused by infusion of fat emulsion （C14-24）

1例86岁女性患者因不全肠梗阻合并下消化道出血，给予禁食、止血、抑酸治疗，同时静脉滴注20%脂肪乳注射液（C14-24）250 ml，1次/d；50%葡萄糖注射液60 ml，1次/d；5%复方氨基酸注射液（18AA-Ⅱ）250 ml，1次/d。第2天起，患者陆续出现发热、心动过速、房颤反复发作等症状；第7天实验室检查示血清三酰甘油（TG）10.8 mmol/L，总胆固醇（TC）15.5 mmol/L，天冬氨酸转氨酶（AST）248 U/L，丙氨酸转氨酶（ALT）100 U/L，遂停用脂肪乳。7 d后复查，患者TG 8.1 mmol/L，TC 10.1 mmol/L，AST 62 U/L，ALT 17 U/L，心脏症状好转。诊断为脂肪乳导致的脂肪超载综合征，但发热未能控制，考虑为医院感染，患者最终因感染并发多器官衰竭死亡。

The patient was an eighty-six years old women suffered from incomplete intestinal obstruction and gastrointestinal bleeding. She was treated with abrosia, hemostatic and antacid agents. At the same time, 20% fat emulsion （C14-24） （250 ml, once daily）, 50% glucose （60 ml, once daily）, and 5% compound amino acid injection （18 AA-Ⅱ） （250 ml, once daily） were given. On the second day of treatment, the patient showed symptoms of fever, tachycardia, recurrent atrial fibrillation and nausea. After seven days treatment, her laboratory results showed serum triglyceride 10.8 mmol/L, total cholesterol 15.5 mmol/L, aspartate aminotransferase （AST） 248 U/L, alanine aminotransferase （ALT） 100 U/L. After stopping fat emulsion for seven days, her laboratory results were serum triglyceride 8.1 mmol/L, total cholesterol 10.1 mmol/L, AST 62 U/L, ALT 17 U/L, and heart symptoms improved. Fat overload syndrome caused by infusion of fat emulsion was diagnosed. Although the symptoms were improved after the discontinuation of fat emulsion, the patient died of concurrent infection and multiple organ failure.