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目的:观察结构脂肪乳剂(STG)和物理混合的中长链脂肪乳剂(MCT/LCT)对胃肠肿瘤病人静息能量代谢和脂质过氧化的影响。方法:对择期手术的胃肠道肿瘤病人64例,随机分为STG组和MCT/LCT组,于术后第2～6天分别使用STG和MCT/LCT构成的等氮、等热量PN支持,共5 d。术后第1至第6天检测病人静息能量代谢、氮平衡和血清超敏C-反应蛋白,术后第6天抽取静脉血行脂质过氧化水平检测。结果:两组病人术后静息能量代谢均较术前明显升高,STG组病人明显低于MCT/LCT组(P<0.05);两组病人采用STG和MCT/LCT的PN治疗后氮平衡均有改善,而STG组病人累计氮平衡值明显高于MCT/LCT组病人(P<0.05)。STG组病人血清中丙二醛和谷胱甘肽过氧化物酶水平亦明显低于MCT/LCT组(P<0.05)。结论:对胃肠肿瘤病人,在减轻脂质过氧化损伤和维护能量代谢稳定方面,STG比MCT/LCT更为优越。
OBJECTIVE: To observe the effects of structural lipid emulsion (STG) and physically mixed long-chain fat emulsion (MCT / LCT) on resting energy metabolism and lipid peroxidation in patients with gastrointestinal tumors. Methods: Sixty-four patients with gastrointestinal cancer who underwent elective surgery were randomly divided into two groups: STG group and MCT / LCT group. Nitrogen and isothermal calorie-based PN supported by STG and MCT / A total of 5 d. Resting energy metabolism, nitrogen balance and serum high-sensitivity C-reactive protein were detected on the first postoperative day to the sixth postoperative day. Venous blood lipid peroxidation levels were measured on the sixth postoperative day. Results: The postoperative resting energy metabolism was significantly higher in both groups than in the preoperative group, and was significantly lower in the STG group than in the MCT / LCT group (P <0.05). Nitrogen balance was significantly lower in both groups after treatment with STG and MCT / LCT (P <0.05). However, the cumulative nitrogen balance in patients with STG was significantly higher than that in patients with MCT / LCT (P <0.05). Serum malondialdehyde and glutathione peroxidase levels in patients with STG were also significantly lower than those in MCT / LCT group (P <0.05). CONCLUSIONS: In patients with gastrointestinal tumors, STG is superior to MCT / LCT in reducing lipid peroxidation and maintaining energy metabolism.