脂肪乳在肠外营养中的应用进展

The development of lipid emulsion in parenteral nutrition

脂肪乳作为肠外营养支持中主要的能量来源 ,数十年来 ,已发展出多种不同配方的制剂。LCT脂肪乳由于代谢方面的缺陷 ,目前在临床上已被MCT/LCT脂肪乳逐步取代。较新的配方是由结构三酰甘油或橄榄油构成 ,此种新型脂肪乳更为安全 ,耐受性更好。含鱼油 (n 3脂肪酸 )的脂肪乳 ,可改善不同病人危重情况下的组织灌注。最新的脂肪乳SMOF ,由添加维生素E的大豆长链脂肪酸、中链脂肪酸、橄榄油和鱼油混合配制而成 ,已在一项双盲试验中获得良好的应用 。

Lipid emulsion, as an energy donor in parenteral nutrition, has been developed in many different concepts over the past decades. Because of immunosuppressive effects, LCT emulsion has been replaced by MCT/LCT emulsion. Newer preparations based on structured triglycerides or olive oil appear to be safe and tolerated. Fish oil (n 3 fatty acids) containing lipid emulsion seems promising for hemodynamic stability in different organ systems of critically ill patients. A new type of emulsion made of a physical mixture of soybean LCT, MCT, olive oil and fish oil supplemented with vitamin E (SMOF) has been developed. This novel emulsion has been proven to be effective in a double blind randomized study.