OBJECTIVE:To compare the effects of structured triglyceride (STG) and medium/long chain triglycerides (MCT/ LCT) on liver function and serum lipid in critical patients.METHODS:80 critical patients were randomized into study group and control group.Both groups were given parenteral nutrition support,50％ Glucose injection 300 ml,Compound amino acid injection 500 ml,trace elements,insulin,vitamin,electrolyte,etc.Study group was additionally given 20％ STG injection 250 ml.Control group was additionally given 20％ MCT/LCT injection 250 ml.They were injected with relevant medicines within 16-18 h/d for 10 days.The liver function and serum lipid in critical patients of 2 groups were detected,and the occurrence of ADR was observed.RESULTS:Liver function of both groups had no significant change after medication,and was in the normal range.The triglyceride and cholesterol didn't obviously elevate in study group after giving STG injection,but the triglyceride and cholesterol obviously elevated in control group after giving MCT/LCT injection:there was statistical significance between 2 groups(P＜0.05).The incidence of ADR had no statistical significance between 2 groups (P＞0.05).CONCLUSIONS:Both two lipid emulsions are safe and effective in parenteral nutrition support for critical patients.But serum lipid have elevated after using MCT/LCT,if those patients have metabolic disorder originally.So,we prefer to select STG for those patients.%目的:比较结构脂肪乳(STG)与中/长链脂肪乳(MCT/LCT)对危重症患者肝功能和血脂的影响.方法:将80例危重症患者随机均分为研究组和对照组.两组患者均采用肠外营养支持,给予50％葡萄糖注射液300ml、复方氨基酸注射液500ml以及微量元素、胰岛素、维生素、电解质等,研究组同时给予20％ STG注射液250 ml;对照组同时给予20％ MCT/LCT注射液250mi.两组输注时间控制在16～18 h/d,输注疗程均为10d.检测两组患者输注脂肪乳前、后肝功能和血脂指标,并观察不良反应发生情况.结果:两组患者输注脂肪乳后肝功能指标变化不大,均在正常范围内；研究组患者输注STG后胆固醇及甘油三酯未出现显著升高,而对照组患者输注MCT/LCT后胆固醇及甘油三酯均有显著升高,组间比较差异有统计学意义(P＜0.05).两组患者不良反应发生率比较差异无统计学意义(P＞0.05).结论:两种脂肪乳剂在危重症患者肠外营养支持中的应用均安全、有效,不良反应少,但对于本身存在血脂代谢异常的患者,应用MCT/LCT后易导致血脂进一步升高,故这部分患者选择STG更合适.
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