肠内营养制剂产品配方评价

Formulation evaluation of enteral nutrition preparations

目的了解肠内营养制剂配方的差异,以便选出最佳产品。方法收集市场上主要的肠内营养(enteral nutrition,EN)产品说明书;结合作者工作经验,对市场上主要EN产品成分、含量以及来源等信息进行数据采集并分类;并根据供能密度换算能量密度指标,供能比例、非蛋白热卡与氮比值;根据配方成分和能量比例,结合现有临床证据和指南对产品进行评价。结果收集到肠内营养产品说明书27份。氨基酸型/短肽型(要素型/半要素型)产品有5个,主要适用于胃肠功能不全的患者;整蛋白型(非要素型)产品有22个,主要适用于胃肠功能正常患者。其中平衡标准型配方制剂有11个,包括高能量密度、含膳食纤维、含中链甘油三脂配方;疾病特异型配方制剂11个,包括糖尿病型和减肥型、肿瘤型、免疫增强型、肝病型、肾病型和肺病型等。结论根据患者的疾病特点和肠内营养产品的特征,选择最合适的肠内营养制剂。标准配方制剂的成本较低,大多数患者可以耐受,建议尽可能选用。

ObjectiveTo identify the differences in the enteral nutrition(EN)formulas in order to select the best product for the patient. MethodsEN product instructions on the market were gathered.Based on the author′s work experience,the information of ingredients,content,sources were collected and classified.Energy ratio indicators,non-protein calorie and nitrogen ratio indicators were calculated according to energy density.The products were evaluated according to the ingredients and energy ratio of the formulation,combined with the existing clinical evidence and guidelines. ResultsTotally 27 instructions of EN products were collected.There were 5 amino acid/short peptide(element/semi-element)formulas,which were mainly suitable for patients with gastrointestinal dysfunction,and 22 polymeric formulas(non-element),which were mainly suitable for patients with normal gastrointestinal function.There were 11 balanced standard formulas,including high energy density,dietary fiber,medium chain triglyceride formula;11 disease-specific formulas,including diabetes,weight loss,tumor,immune enhancement,liver disease,nephropathy and lung disease formula. ConclusionThe most appropriate EN formula should be identified according to the patient′s disease and the characteristics of EN products.Standard formulas have a lower cost and are tolerated by most patients and are recommended to be used as much as possible.