静脉输注长链及中/长链脂肪乳剂对脂蛋白代谢的影响

Lipoprotein Metabolism During Infusion of MCT/LCT vs LCT Emulsion in Human

目的比较静脉输注长链甘油三酯(LCT)及中长链甘油三酯(MCT/LCT)脂肪乳剂时血浆脂蛋白代谢。方法选择12例健康志愿者进行前瞻性随机交叉对照研究,连续输注MCT/LCT或LCT6h,测定输注前及输注中4、6、8、12及24h时血清甘油三酯(TG)、游离脂肪酸(FFA),血磷酯(PL)、游离胆固醇(FC)、胆固醇酯(CE)含量以及血浆各脂蛋白成份。结果脂肪乳剂输注过程中,MCT/LCT组血清TG浓度明显低于LCT组,而血浆FFA浓度约为LCT组的3倍(P<0.001),MCT/LCT的半衰期(68±12)min明显短于LCT(116±18)min(P<0.05)。LCT组血浆FC浓度明显高于MCT/LCT组(P<0.05),而血浆胆固醇酯(CE)浓度两组均无明显变化。结论MCT/LCT的水解、代谢清除率明显高于LCT,MCT/LCT输注时TG与低密度脂蛋白之间转换率较高,脂肪颗粒较少获取CE,其残余颗粒的清除也高于LCT。

Objective The purpose of the present study was to compare,in vivo,the i nt ravascular metabolism and the affects lipoprotein pattern of MCT/LCT and LCT in healthy subjects.Methods In a randomized cross-over study,plasma kinetics of two different types of fat emulsions were studied in12healthy volunteers du ring and after a6-h infusion of fat emulsions.Results The hydrolysis and elimi nation rate of MCT/LCT were significantly greater than LCT.The rise of plasma FFA concentration was greater with MCT/LCT(P<0.01).LDL-TG enrichment wa s higher with MCT/LCT (P<0.05),CE-VLDL was markedly less during MCT/LCT than LCT infusions (P<0.01).Conclusions In conclusion,TG from MCT/LCT emulsion appear to be eliminated faster than LCT.MCT/LCT infusion was associate d with a higher transfer of TG to LDL and in a reverse manner,with a lesser acq uisition of CE by emulsion particles as compared to LCT infusion.