A nders T harne 3 Jo rgen N o rden strom 3
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1 6 1 V o l. 6 N o. 1 3 A nders T harne 3 Jo rgen N o rden strom 3 :, : 16, 7 20% Intralip id 20% Structo lip id 4 h (0. 25 g T Ggkg h - 1 ) 9 6 h (0. 17 g T Ggkg h g gkg h - 1 ) Β2 32 :,,, Β2 (DC10) 32 (32OHC8), : R ) kggm 2, 2 ; 1 4 8: 00,,,, Β2, 20% In tralip id ( L CT, Phar2 m acia & U p john, Sw eden ) 20% Struc2 to lip id ( ST G, Pharm acia & U p john, Sw eden) 1,, 7 ( In tralip id Structo lip id ) 4 h (0. 25 g T Ggkg h - 1 ) ; 9, ( In tralip id Structo lip id) 6 h (0. 17 g T Ggkg h g gkg h - 1 ) 1 16 (Ch ild A - B ), 54 (38 66), 71 (63 84) kg, BM I= 25 (21 Ξ (, ) 3 D epartm ent of Surgery, H uddinge U niversity Ho sp ital, Karo linska Institute, Sw eden
2 , g ( 1),,,, ST G L CT (P 2 h 3 h 4 h < 0. 05) Β2 32, ( 2) (OHC8) (DC10), Β2 32, 2,, 32,,, Β2 (ANOVA ) Stu2 den t t, P < 0. 05, (DC10) 32 (32OHC8), 1 20% Intralip id 20% Structo lip id, T ab. 1 T he compo sition of the ST G and L CT Β2 g1 000 m l ST G L CT (g) STG (g) (g) (g) (k j) ph F ig. 1 T herm ic effect of tw o fat em ulsions 2, 3 (ST G 2, L CT 1 ), 2 F ig. 2 Changes in resp irato ry quo tient hefo re and, after infusion of tw o em ulsions
3 1 3 2 Β2 32 T ab. 2 B lood levels of various blood substrates befo re and during study LCT STG LCT + G STG+ G T G FFA Β (DC10) (32OHC8) ST G L CT P < , 10, 8 10,, C8 C , 1 ST G C8 Β2, 32 8 M ller L CT M CT gl CT, Β2,, 32 A, (M CFA ) 5 T ho rne (L CFA ), M CFA (10 ) Ξ, 6, Β2,, C10 11, 7, 8 C10,, ST G, ST G L CT,, ST G, 32, ST G L CT,,,,, ST G, L CT, ST G L CT,, ST G L CT 1 (FFA ),
4 6 1 V o l. 6 N o. 1 T PN : : T PN (rhgh ) 23, T PN : rhgh, ( ) ( ) (P < 0. 05); rhgh 7 ( ) ggl, ( ) ggl, (P < 0. 05); 3 7 rhgh, ; rhgh, : rhgh,,, T PN R ,, T PN,, rhgh (rhgh ) (, ) T PN rhgh 23,,, 1 M egyesi C, Samo ls E,M ark s V. Gluco se to lerance and diabetes in chronic liver disease. L ancet, 1967, 2: M archesini G, Fo rlanic G, Zo li M, et al. Insulin and glucagon levels in liver cirrho sis. D ig D is Sci, 1979, 24: Rudm an D, Sew ell GW, A nsley JD. D eficiency of car2 nitine in cachetic cirrho tic patients. J C lin Invest, 1977, 60: M erlim, E rik sson L S, H agenfeldt L, et al. Sp lanchnic and leg exchange of free fatty acids in patients w ith liver cirrho sis. J H epato l, 1986, 3: M ller M J, R ieger A,W illm ann O, et al. M etabo lic re2 sponses to lip id infusions in patients w ith liver cirrho2 sis. C lin N utr, 1992, 11: T ho rne A, Johansson U,W ah ren J, et al. T hermogenie response to intravenous nutrition in patients w ith cir2 rho sis. Hournal of H epato logy, 1992, 16: M uscarito li M, Cangiano C, Cascino A, et al. Ex2 openons lip id clearance in compensated liver cirrho sis. JPEN, 1986, 10: O no J, H utson D G, Dom bro RS, et al. T ryp tophan and hepatic com a. Gastroentero logy, 1978, 74: M ascio li EA, Randall S, Po rter KA, et al. T hermogen2 esis from intravenous m edium 2chain triglycerides. JPEN, 1991, 15: Sandstron R, H yltander A, Ko rner U, et al. Structural triglycerides w ere w ell to lerated and induced increased w ho le body fat oxidation compared w ith long2chain triglycerides in po stoperative patients. JPEN, 1995, 19: M o rtensen PB. D icarboxylic acids and the lip id m etabo lism. D anish M edical Bulletin, 1984, 31: 121 ( )
5 6 1 V o l. 6 N o. 1 ENGL ISH ABSTRACTS OF OR IGINAL ARTICL ES Thermogen ic and metabolic response of structured lipid emulsion in patients with liver fa ilure W u Guohao,W u Zhaohan,A nders T harne, et a l D ep artm ent of S u rg ery, Z hong shan H osp ital, S hang hai M ed ical U niversity (S hang hai, ) Abstract O bj ectives: To exam ine w hether the thermogenic and m etabo lic response of structured triglyc2 eride (ST G) is different from that of long chain triglyceride (L CT ) in patients w ith liver cirrho siṡ M ethods: Sixteen overnigh t fasted patients w ith liver cirrho sis w ere exam ined befo re and after adm inistration of ST G o r L CT. T he patients w ere random ly allocated to tw o treatm ent o rder group s in an open cro ss2over study. T he energy expenditure w as determ ined w ith indirect calo rim etry befeo re and then th roughout the study period. Individual free fatty acids (FFA ) w ere analyzed by H PL C, dicarboxylic acids (DC) in urine and p lasm a and 32 hydroxy fatty acids (3OH FA ) in p lasm a w ere analyzed by gas ch rom atography2m ass spectrom etry. Results: T he infusion of ST G w as found to be accompanied by tw o2fo ld greater therm ic effect and the resp irato ry quo2 tient tended to be low er in comparison w ith the infusion of L CT. Infusion of ST G w as associated w ith appear2 ance of DC and 32OH FA in p lasm a but a sligh tly above the detection level fo llow ing adm inistrating of L CT. Conclusions: In patients w ith liver cirrho sis adm inistration of ST G in comparison w ith L CT is accompanied by a mo re m arked hydro lysis as w ell as a tw o2fo ld greater thermogenic response. Fat em ulsions containing m edi2 um 2chain triglyceride ough t to be adm inistrated at a relatively slow rate in o rder to avo id po tential adverse ef2 fects due to an over loaded m etabo lism. Key words Structu red triglyceride L ong2chain trighyceride L iver cirrho sis The study on cura tive effect of TPN and rhgh in surg ica l pa tien ts Xu Pengyuan, Gan P ing, Xu Sh icai, et a l D ep a rtm en t of Genera l S u rg ery, the 2nd A f f ilia ted H osp ita l, K unm ing M ed ica l Colleg e (K unm ing, ) Abstract O bj ectives: To ob serve the effectiveness of T PN and recom b inan t hum an grow th ho rm one ( rhgh ) in patien ts receiving su rgical operation. M ethods: Fo rty2six pa2 tien ts w ere random ly divided in to tw o group ṡ O ne group received on ly T PN as con tro l, and ano ther group received T PN and rhgh (rhgh group ). Resu lts: T he rate of infective com 2 p lication w as decreased and ho sp italisation tim e sho rtened in rhgh group. T he concen tra2 tion of p lasm a album in w as increased sign ifican tly at the 7th operative day in rhgh group. Conclusions: rhgh cou ld im p rove negative n itrogen and increase the concen tration of p lasm a album in in operated patien tṡ
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