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The changes of serum β-hydroxybutyrate concentrations in patients after receiving medium chain triglycerides (MCT) or long chain triglycerldes (LCT) were studied. The patients were divided into two groups, in Group 1, the dose of fat was 0.14g/kg·h for fat emulsion clearance test, and in Group 2, the dose was 0.06g/kg·h for total parenteral nutrition (TPN) support.The β-hydroxybutyrate concentrations were estimated by an enzymatic method using Sigma's β-hydroxybutyrate kit (Sigma Diagnostics, MO 63178, USA).... The changes of serum β-hydroxybutyrate concentrations in patients after receiving medium chain triglycerides (MCT) or long chain triglycerldes (LCT) were studied. The patients were divided into two groups, in Group 1, the dose of fat was 0.14g/kg·h for fat emulsion clearance test, and in Group 2, the dose was 0.06g/kg·h for total parenteral nutrition (TPN) support.The β-hydroxybutyrate concentrations were estimated by an enzymatic method using Sigma's β-hydroxybutyrate kit (Sigma Diagnostics, MO 63178, USA). The normal range of P-hydroxybutyrate concentration in 30 healthy Chinese subjects was 1.04 ± 1.42mg/dl (range 0-3.88mg/dl) .In Group 1, we found that the concentrations of β-hydroxybutyrate, , rose steadily after fat emulsion infusion. The concentrations in the medium chain: triglyceride group were higher than those in long chain triglyceride group. The elevated concentrations of P-hydroxybutyrate gradually returned to normal levels when the emulsion infusion was stopped. In Group 2 the concentrations, of β-hydroxybutyrate in the patients were within the normal range. 应用酶促法研究了输入不同链长的脂肪乳剂后病人血中酮体的变化。其中第一组8例病人接受输入剂量为0.14g/kg.h的中链或长链脂肪乳剂的廓清实验,第二组的12例病人在肠外营养(total parenteral nutrition,TPN)接受输入剂量为0.06g/kg.h的中链或长链的脂肪乳剂。而且还测定了30例正常人(男女各15例)血清β-羟丁酸的含量。研究结果,表明中链脂肪乳剂在廓清剂量时,血中酮体高于正常水平,而在常规胃肠外营养支持时,中链脂肪乳剂或长链脂肪乳剂均无血酮体升高现象,在临床上应用是安全的。 Objective:To compare the metabolism of longchain triglycerides(LCT) and mediumchain triglycerides (MCT) in ischemic acute renal failure (ARF).Methods:SpragueDawley rats were divided into four groups:LCT normal group,LCT ARF group,MCT normal group and MCT ARF group.10% Intralipid (LCT) or 10% Lipofundin (MCT) in a dose of 0 3 g/kg was injected as a bolus to animals via the tail vein.The serum triglycerides were measured at 2,10,40,70,100,130 and 160 minutes after injection for pharmacokinetics analysis.Results:The... Objective:To compare the metabolism of longchain triglycerides(LCT) and mediumchain triglycerides (MCT) in ischemic acute renal failure (ARF).Methods:SpragueDawley rats were divided into four groups:LCT normal group,LCT ARF group,MCT normal group and MCT ARF group.10% Intralipid (LCT) or 10% Lipofundin (MCT) in a dose of 0 3 g/kg was injected as a bolus to animals via the tail vein.The serum triglycerides were measured at 2,10,40,70,100,130 and 160 minutes after injection for pharmacokinetics analysis.Results:The elimination rate constant ( K e) of LCT ARF group was significantly less than that of LCT normal group,while the halflife period (t 1/2 ) of it was longer.The K e and t 1/2 of MCT ARF group showed no statistical difference with MCT normal group.In normal group,the K e of LCT was significantly decreased compared with MCT while the t 1/2 of it was significantly prolonged.In ARF group, K e of LCT was much less than that of MCT while t 1/2 of it was much longer.The serum insulin levels of both MCT groups were higher than those of LCT groups.Conclusions:It showed that MCT could be cleared rapidly in rats with ARF.MCT may improve the secretion of insulin and balance of nitrogen in ARF,and may be more favorable than LCT in the nutritional treatment of ARF. 目的:比较长链脂肪乳剂(LCT)和中链脂肪乳剂(MCT)在急性缺血性肾功能衰竭大鼠中的代谢特点。方法:大鼠分成LCT正常组、LCT肾衰组、MCT正常组和MCT肾衰组。从尾静脉注射0.3g/kg的10%英脱利匹(LCT)和10%力波肪定(MCT),在注射后2、10、40、70、100、130及160分钟测血甘油三酯浓度以行药代动力学分析。结果:LCT在肾衰组中的清除速率常数(Ke)明显小于正常组,半衰期(t1/2)则明显大于正常组。MCT在肾衰组的Ke和t1/2与正常组相比无明显差异。在正常组中,LCT的Ke较MCT明显减少,而t1/2则明显延长。在肾衰组中,LCT的Ke较MCT进一步减小,t1/2则更明显延长。2组MCT组的大鼠血清胰岛素均较LCT组有明显升高。结论:MCT在肾衰大鼠体内被清除速度快,能促进胰岛素的分泌,有助于改善急肾衰时的氮平衡。MCT在急肾衰中的应用较LCT更为优越 MCT possess several unique physical,chemical and structural characteristics and is a more desirable substrate than LCT for clinical nutrition.The clinical data comparing the efficacy of MCTbased fat emulsions to their LCT counterparts have yielded equivocal results.This review attempts to summarize the evidence concerning the clinical use of MCT as an intravenous fat,and compare the effects with conventional LCT preparation in various clinical conditions. 由于中链脂肪乳剂的结构、生化特征 ,具有氧化快而完全、较少依赖肉毒碱转运等优点 ,目前已普遍应用于临床营养支持。但是 ,临床上有关中链脂肪乳剂与传统的长链脂肪乳剂在各领域中应用的比较研究却较少 ,而且结果相差很大。本综述通过总结临床上有关中、长链脂肪乳剂的前瞻性随机对照研究资料 ,比较中、长链脂肪乳剂在临床上各种情况下的应用结果
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