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结构脂肪乳对肝硬化患者氮平衡及蛋白质代谢的影响
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结构脂肪乳对肝硬化患者氮平衡及蛋白质代谢的影响
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Journal Article
结构脂肪乳对肝硬化患者氮平衡及蛋白质代谢的影响
2012
Overview
目的比较结构脂肪乳（STG）和中长链脂肪乳（MCT/LCT）对肝硬化患者氮平衡及蛋白质代谢的影响,进一步评估STG的临床疗效。方法纳入解放军105医院消化内科2010年3-10月被诊断为肝硬化的患者26例,分为STG组（17例）和MCT/LCT组（9例,MCT与LCT物理混合）。两组患者于住院后第1~6天接受肠外营养,根据体重计算患者每日所需营养支持量。对比观察两组患者氮平衡、肝脏酶学指标（ALT、AST、TBIL）、血浆蛋白质[前白蛋白（PA）、白蛋白（ALB）]水平及临床营养测量指标。结果治疗过程中,有3例患者退出,其中STG组2例,MCT/LCT组1例。两组患者临床特征无统计学差异（P〉0.05）。在进行6d的肠外营养后,STG组（6.4±2.1g）患者累积氮平衡值明显高于MCT/LCT组（2.8±2.3g,P〈0.05）;两组患者PA和ALB水平均较治疗第1天上升（P﹤0.05）;两组肝脏酶学指标及血浆蛋白质水平与治疗第1天比较均无统计学差异（P〉0.05）;临床营养测量指标三头肌皮褶厚度和上臂肌围与治疗第1天比较无明显差异,两组之间亦无明显差异（P〉0.05）。结论 STG比MCT/LCT具有更好的氮平衡,能有效改善蛋白质代谢,促进肝硬化患者的恢复。
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