Intralipid研究与应用文献的定量分析及发展趋势预测

Intralipid是一种重要的静脉用脂肪乳剂 ,自 80年代以来 ,已被广泛应用于临床各科重危病人以改善营养状况 ,增强机体抵抗能力 ,提高治愈率 ,降低死亡率 ,并延长病人的寿命。作者用文献计量学的线性回归分析法 ,对 1980 1994年的MEDLINE光盘文献数据库中有关Intralipid的研究和应用文献进行了定量分析 ,发现年度文献量与时间变化有显著的线性相关关系。在1980 1994年 ,平均每年增长 1.16篇。以此回归方程对 19951999年的文献进行预测 ,预计平均每年将以 2 .0 7%的比率增长。由此可知 ,对Interlipid的研究已趋稳定 ,只要在实际应用中持科学和慎重的态度 。

脂肪乳剂Intralipid对急性肺损伤气体交换及组织形态学的影响

为对比研究脂肪乳剂Intralipid和葡萄糖对急性肺损伤气体交换及组织学的影响 ,我们对肺损伤家兔进行不同制剂的肠外营养液输注。研究结果表明 ,糖脂组呼吸次数、PaO2 、PaCO2 及pH无明显改变 ,而全糖组在 4 8hPaO2 和 pH均有显著下降 (P <0 .0 5) ,PaCO2 有升高。组织形态学检查表明 ,炎症及坏死性病变的检出率以糖脂组为低 。

30％与20％Intralipid对血脂代谢影响的研究

为观察３０％Ｉｎｔｒａｌｉｐｉｄ与２０％Ｉｎｔｒａｌｉｐｉｄ两种脂肪乳剂对血脂代谢的影响，本文以４０例外科非应激与无代谢异常病人为对象，随机分为Ｉｎｔｒａｌｉｐｉｄ３０％组与Ｉｎｔｒａｌｉｐｉｄ２０％组，分别经外周静脉给予等热量的３０％Ｉｎｔｒａｌｉ...

脂肪乳剂Intralipid对急性肺损伤自然病程的影响

３２只新西兰大白兔随机分为四组，即正常对照组、内毒毒对照组、全糖肠外营养组和糖脂肠外营养组。肠外营养两组间的热、氮及液体量相等。全糖组能源以葡萄糖为主，糖脂组由脂肪乳剂和葡萄糖提供。实验组动物在内毒素诱发急性肺损伤后，连续肠外营养液输注４８ｈ，对临床...

脂肪乳剂Intralipid对急性肺损伤兔肺表面活性物质及其肺功能的影响

用大肠杆菌内毒素静脉注射诱发兔急性肺损伤动物模型，同时肠外营养（ＰＮ）液输注持续４８ｈ。两个ＰＮ组的热、氮及液体量均相等，全糖组能源由葡萄糖供给，糖脂组由脂肪乳剂和葡萄糖供给。结果显示，糖脂组肺系数、白蛋白指数均明显降低（Ｐ＜０．０１）；支气管肺泡灌...

Intralipid对吞噬细胞氧自由基产生的影响

目的：观察Ｉｎｔｒａｌｉｐｉｄ对内毒素所致的多形核白细胞氧自由基产生的影响。方法：取２２例健康志愿者静脉血，采用Ｂｏｙｕｍ法提取多形核白细胞（ＰＭＮ），并在体外培养。采用不同剂量的脂多糖（ＬＰＳ）刺激ＰＭＮ，并和不同剂量Ｉｎｔｒａｌｉｐｉｄ共同作用。采用ＮＢＴ还原试验测定氧自由基的产生量。结果：ＬＰＳ刺激各组的ＮＢＴ值明显高于非刺激组，而且ＮＢＴ值与ＬＰＳ浓度明显相关。Ｉｎ－ｔｒａｌｉｐｉｄ可明显降低ＮＢＴ值，且ＮＢＴ值与Ｉｎｔｒａｌｉｐｉｄ浓度呈负的线性相关。结论：不论有无内毒素刺激，Ｉｎｔｒａｌｉｐｉｄ在体外均可抑制吞噬细胞产生氧自由基。

脂肪乳剂Intralipid对急性肺损伤兔前列腺素代谢及其肺功能的影响

为研究脂肪乳剂对急性肺损伤兔前列腺素代谢的影响 ,我们对实验动物予以肠外营养 ,持续静脉输注脂肪乳剂 4 8h。结果糖脂组血中及支气管肺泡灌洗液中血管紧张素转化酶( ACE)、超氧化物岐化酶 ( SOD)含量明显下降 ( P<0 .0 1) ,前列环素 ( PGI2 )、血栓素 ( TXA2 )及其PGI2 / TXA2 比值有明显升高 ( P<0 .0 1) ,灌洗液 ( BAL F)中细胞计数糖脂组明显下降 ( P<0 .0 1)。结果提示 ,脂肪乳剂可能通过调节前列腺素的合成 ,抑制中性粒细胞在肺内聚集及炎症反应 。

30%与20%Intralipid对血脂代谢的影响

３０％与２０％Ｉｎｔｒａｌｉｐｉｄ对血脂代谢的影响为观察３０％Ｉｎｔｒａｌｉｐｉｄ与２０％Ｉｎｔｒａｌｉｐｉｄ两种脂肪乳剂对血脂代谢的影响，本文以４０例外科非应激与无代谢异常病人为对象，随机分为３０％组与２０％组，分别经外周静脉予等热量的３０％Ｉｎｔ...

Intralipid for Amniotic Fluid Embolism (AFE)?

In 1998 it was first showed that intravenous Intralipid could prevent or improve resuscitation from cardiovascular collapse by severe bupivacaine overdose in rats. Since then published examples now include toxicities related to verapamil, diltiazem, amlodipine, quetiapine and sertraline, haldoperidol, lamotrigine, olanzapine, propranolol, atenolol, nevibolol, doxepin, dosulepin, imipramine, amitriptyline, glyosphate herbicide, flecainide, venlafaxine, moxidectin, and others. Amniotic fluid embolism (AFE) is a rare but potentially catastrophic obstetric emergency. Despite earlier recognition and aggressive treatment, morbidity and mortality rates remain high. An estimated 5% - 15% of all maternal deaths in Western countries are due to AFE. The pathophysiology of AFE is not completely understood. AFE most commonly occurs during labor, delivery, or the immediate postpartum period. However, it has been reported to occur up to 48 h postpartum. Pulmonary hypertension and right heart strain/failure may be the result of physical amniotic fluid debris in the pulmonary vasculature or, perhaps more likely, result from circulating pulmonary vasoconstrictive mediators. Therapy with Intralipid in male rats resulted in 100% survival and prevented Pulmonary arterial hypertension-induced right ventricular failure by preserving right ventricular pressure and right ventricular ejection fraction and preventing right ventricular hypertrophy and lung remodeling. In preexisting severe Pulmonary arterial hypertension, Intralipid attenu-ated most lung and right ventricular abnormalities. The beneficial effects of Intralipid in Pulmonary arterial hypertension seem to result from the interplay of various factors, among which preservation and/or stimulation of angiogenesis, suppression and/or reversal of inflammation, fibrosis and hypertrophy, in both lung and right ventricular, appear to be major contributors. In conclusion, Intralipid not only prevents the development of Pulmonary arterial hypertension and right ventricular failure but also rescues preexisting severe Pulmonary arterial hypertension. Intralipid treatment is a new treatment for AFE (amniotic fluid embolism) which was never suggested before. Animal studies should be done in order to evaluate this new treatment modality.

Combined Spinal Epidural Catheters for Epidural Cooling, Cerebrospinal Fluid Aspiration and Spinal Intralipid Infusion for Treatment of Spinal and Brain Injuries, Diseases and Protection

A new proposal for spinal cord and brain treatment and protection due to injuries and diseases is made herein. It is composed of two 20G nylon catheters with 6 lateral holes arranged circumferentially within 3 cm from the tip and a closed end. One catheter is inserted into the epidural space and the other catheter is inserted into the spinal space in two different lumbar interspaces using an 18G Tuohy needle 90 mm. The epidural catheter is used for cooled saline injection and infusion. The spinal catheter is used for Intralipid spinal injections and CSF aspiration. The proposal is based on the current studies on spinal cord cooling and CSF aspiration as well as on the Intralipid resuscitation properties and lipid brain protection. A study is needed to evaluate the clinical value of this combined approach.

Study of the Effect of Intralipid Infusion during Pregnancy as an Additive Treatment for Reducing Pregnancy Complications Caused by Antiphospholipid Antibody Syndrome

Aim: To evaluate the safety and efficacy of intralipid infusion in addition to other lines of treatment in reduction of complications caused by antiphospholipid antibody syndrome. Methods: This study was held in the period from June 1, 2016, to December 1, 2019. This study was conducted in the Department of Obstetrics and Gynecology, Tanta University on patients attending the antenatal care clinic and also on patients attending the researcher’s private clinics for antenatal care, 105 patients were enrolled after application of strict inclusion and exclusion criteria. They were randomized into 2 groups. In group A (study group 1) the patients received in addition to the conventional basic treatment of APS, intralipid 20% (Frezenius, Clayton, NC, USA) in a dose of 4 ml diluted in 250 ml 0.9% regular saline IV and to be repeated every 2 weeks. In group B (control group 2) the patients received the conventional basic treatment of APS. The outcome measures were the incidence of pregnancy complications of APS namely fetal loss, premature delivery, IUGR and preeclampsia. Results: 49 patients were enrolled in the study group, and 48 patients were enrolled in the control group, after exclusion of the skipped cases. The demographic data and the gestational age at the beginning of the study show insignificant differences. There were insignificant differences as regard the gestational age at which the pregnancy was terminated and fetal birth weight in patients with positive ACL test, positive LA test and positive B2 however the mean gestational age at which pregnancy was terminated was higher in study group. Also, there was insignificant difference as regards no of patients who complicated with abortion or who completed to full term. But had significant decrease number of case who complicated with preeclampsia (8, 21 patients in study and control group respectively). Conclusion: Intralipid infusion is a promising treatment option for control and prevention of problems caused by antiphospholipid antibody syndrome.

Intralipid对巨噬细胞产生一氧化氮的抑制作用

测定Ｉｎｔｒａｌｉｐｉｄ在体外是否影响内毒素和细胞因子所致的巨噬细胞的一氧化氮自由基的产生。方法：采用腹腔灌洗收集２０只ＳＤ大鼠的腹腔巨噬细胞，在体外置３７℃、５％ＣＯ培养箱中孵育，应用大肠杆菌脂多糖和γ－干扰素刺激巨噬细胞。实验分单纯巨噬细胞组和加用Ｉｎｔｒａｌｉｐｉｄ组，采用Ｇｒｉｅｓｓ反应测定ＮＯ的产生量。结果：经ＬＰＳ、ＩＦＮ－γ刺激后，巨噬细胞的ＮＯ产生量明显增高（Ｐ＜０．０５）；脂肪乳剂可明显降低各种状态下巨噬细胞的ＮＯ产生量（Ｐ＜０．０５）。结论： Ｉｎｔｒａ－ｌｉｐｉｄ在体外可抑制巨噬细胞介导的一氧化氮自由基的产生。

MRI Investigation of New Approach to Improve the Recovery of Myocardial Ischemia Reperfusion Injury by Treatment with Intralipid®

Background: Despite advances in revascularization and thrombolytic therapy, the outcome of patients after acute myocardial infarction (MI) could be complicated by ischemia reperfusion injury (IRI) and subsequent ventricular remodeling. Inflammation plays a central role in IRI. Intralipid® has been shown to reduce infarct size after IRI, but its effects on myocardial inflammation have not been addressed. The goal of this study is to investigate the effects of Intralipid® on in-situ myocardial inflammation and to better characterize its cardio-protective effects. Methods and Results: Cellular MRI was used to evaluate myocardial inflammation of iron-oxide-labeled macrophage infiltration. Cardiac MRI was used to evaluate global and regional ventricular wall motion, as well as myocardial perfusion and infarction in a rat model. Our results show that the Intralipid® treatment following IRI can preserve global and regional ventricular wall motion, and reduce the infarct size. The In-tralipid®-treated rats exhibit reduced myocardial macrophage infiltration, indicating reduced in-situ myocardial inflammation. Conclusions: Our results indicate that the Intralipid® treatment can protect the heart against IRI and can specifically reduce in-situ myocardial inflammation. Additional study is needed to assess if treatment using Intralipid® after LAD occlusion could improve the recovery of patients suffering from a heart attack and also reduce future development of heart failure.

脂肪乳剂Intralipid对全胃切除后病人脂肪酸代谢的影响

本研究评价手术创伤和手术后静脉输入脂肪乳剂后对手术创伤病人脂肪酸代谢的影响.采用气相色谱法分析6例贲门、胃底癌全胃切除病例术前、术后6h,用含Intralipid全胃肠外营养支持后1、3、5、7天及术后8天开始管饲要素饮食至术后14天血浆脂肪酸浓度变化.结果显示术后6h血浆软脂酸、硬脂酸、油酸、亚油酸浓度显著低于术前(P<0.05,P<0.01).全胃肠外营养支持3、5、7天后,血浆硬脂酸、油酸、亚油酸浓度比术后6h显著升高(P<0.05或P<0.01).术后14天血浆油酸、亚油酸浓度仍比术后6h显著升高(P<0.05)但较全胃肠外营养支持3、5、7天有下降趋势.研究证明,手术创伤后,血浆脂肪酸利用致血浆脂肪酸浓度降低,推荐手术后立即应用含Intralipid全胃肠外营养支持.

20%与10%Intralipid全肠外营养时脂蛋白代谢的比较

作者比较了长期应用10％和20％Intralipid对脂蛋白分布的影响(附表)。10％组13例TPN病人,20％组10例,每天输注脂肪2.0g/kg,超过4周。用超速离心密度梯度法测定血脂和脂蛋白分布;用琼脂糖凝胶电泳法测定脂蛋白-X(LP-X)。

营养不良的血液透析病人较长期输注Intralipid后血清脂蛋白变化的研究

血液透析病人的营养不良是常见的,其营养状况与发病率和死亡率有关.研究表明:肾衰病人血清脂肪代谢有较大紊乱,血液透析病人能很好地氧化利用脂肪乳剂.作者对较长期输注Intralipid血液透析患者详细检测血清脂肪谱,阿朴脂蛋白和脂蛋白,评价Intralipid对肾衰血透析病人有益的程度.

20%Intralipid的临床应用

20%Itralipid是较新的脂肪乳剂,它安全可靠,高能低容,磷脂/甘油三酯比值更接近人体乳糜微粒,渗透压与血浆接近.作者综述了20%Intralipid的临床应用情况.

Application of gastric perfusion intralipid for formulating rabbit's hyperlipidemia models

Background The commonly used method so far for formulating hyperlipidemia animal models is to feed the animals with a high fat diet. Owning to influences of animal feeding, dosage and cycle, feeding with a high fat diet has resulted in an unstable quality. It is unknown whether gastric perfusion of intralipid can establish a better hyperlipidemia model in rabbits. Methods Twenty rabbits were randomly selected and subjected to gastric intralipid perfusion for consecutive 2 weeks or to feed with common high cholesterol feed for 4 weeks. The levels of blood serum total cholesterol （TC）, triglyceride （TG）, apolipoprotein A1 （APOA1）, APOB, blood plasma thromboxane B2 （TXB2）, 6-Keto-prostaglandin F1α （6-Keto-PGF1α）, endotheline （ET）, erythrocyte membrane cholesterol （M-Tc）, membrane fluidity （M-Flu）, erythrocyte malondialdehyde （E-MDA）, erythrocyte superoxide dismutase （E-SOD） before and after the experiment. In the end of the experiment, the aortae were removed from all the animals for light and electron microscopic examinations. Results The results showed that in both groups, the levels of blood serum TC, TG, APOB, blood plasma TXB2, ET, erythrocyte M-Flu and E-MDA were significantly increased. Blood serum APOA1, blood plasma 6-Keto-PGF1α and E-SOD were significantly decreased. But, erythrocyte M-TC had no significantly changed. The indexes of the two groups were no obvious difference before and after the experiment. Light and electron microscopic examination showed that there were early changes of early atherosclosis in the two groups of animal, in accordance with the characteristics of experimental animal hyperlipidemia. Conclusion The results suggest that gastric perfusion of intralipid can produce hyperlipidemia in rabbits faster than the commonly used model developed by feeding high cholesterol diet.

光学相干层析成像系统的蒙特卡罗模拟

将光学相干层析成像系统采样臂的光纤与聚焦系统和被测样品作为一个整体来模拟光学相干层析成像信号的形成机理.通过追迹采样光束中每一光子在聚焦系统和被测样品中的随机传输轨迹,来决定该光子对光学相干层析成像信号是否有贡献及贡献大小.对样品IntralipidTM的模拟结果与实验结果表明:1)高散射系数和弱前向散射是引起光学相干层析成像信号随测量深度增加迅速减弱的主要原因;2)对于确定的聚焦系统,光纤的数值孔径有一最佳取值范围.数值孔径太小,则光学相干层析成像信号很弱;数值孔径超出这一范围继续增大,光学相干层析成像信号变化很小.3)当光纤的光轴偏离聚焦系统的光轴h距离时,光学相干层析成像信号随h的增加而减弱.

肠外营养中脂肪乳剂抑制肝脂肪变性的机理

210克左右Wistar大鼠随机分为五组，在LCT组、MCT／LCT组、GS组中进行等氮、等热量肠外营养（PN）。总热量为300kcal·kg－1·d-1，非蛋白热能：氮＝182：1，LCT组、MCT／LCT组分别由10％的Intralipid和10％的Lipofundin提供30％的非蛋白热卡，7天后，分别测定血脂和肝脂，测定血浆生化指标，并行肝脏病理检查。结果显示：GS组肝细胞胞浆内出现弥漫的脂肪浸润，而LCT组、MCT／LCT组的肝细胞与对照组类似，无脂肪变性。探讨PN中脂肪乳剂抑制肝脂防变性的机理，是由于脂肪乳剂中必需脂肪酸（EFA）使肝脏内的脂肪合成减少，脂肪运出增加，通过代谢调节避免了肝脏脂肪变性。