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題 名 | Efficacy of Medium-chain Triglycerides Compared with Long-chain Triglycerides in Total Parenteral Nutrition in Patients with Digestive Tract Cancer Undergoing Surgery=胃腸道癌症病患術後接受七天中/長鏈脂肪酸脂肪乳劑的臨床效益 |
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作 者 | 陳芳銘; 王照元; 孫麗珠; 莊瑞芬; 黃宗人; 謝建勳; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 21:11 民94.11 |
頁 次 | 頁487-494 |
分類號 | 416.24 |
關鍵詞 | 中鏈脂肪酸; 前白蛋白; 全靜脈營養; Medium-chain triglycerides; Prealbumin; Total parenteral nutrition; |
語 文 | 英文(English) |
中文摘要 | 本篇前瞻隨機性研究目的在評估,針對胃腸道癌症病患,術後接受七天的中/長鏈脂肪酸脂肪乳劑的臨床效益;並比較在血液學檢查及生化指標方面,使用中/長鏈脂肪酸脂肪乳劑與長鏈脂肪酸脂肪乳劑的差異。共有 30 位接受胃癌及大腸癌手術,且需要全靜脈營養治療的病患,被隨機分配成兩組:一組使用中/長鏈脂肪酸脂肪乳劑,另一組使用長鏈脂肪酸脂肪乳劑。經七天治療後,兩組均未產生與脂肪乳劑相關的併發症,且兩組病患在體位測量、住院天數與手術併發症發生率均相同。但是使用中/長鏈脂肪酸脂肪乳劑的病患,血清前白蛋白值有顯著的改善(p = 0.005)。另外,兩組病患在補體 C3、C4、血液全淋巴球數及免疫球蛋白值等免疫功能指標,並未達到統計上的差異。兩組病患在使用脂肪乳劑後,血清膽固醇值及三酸甘油脂值同樣無明顯差異。但血清胰島素值在使用中/長鏈脂肪酸脂肪乳劑的病患中,有較明顯上升(p = 0.048)。本研究顯示,與接受長鏈脂肪酸脂肪乳劑相比較,病患接受七天中鏈長鏈脂肪酸脂肪乳劑,可以更明顯改善營養狀態,有較高的血清前白蛋白值。而造成此一現象的部分原因,可能與接受中/長鏈脂肪酸脂肪乳劑,可產生較高的血清胰島素值有關。 |
英文摘要 | The objectives of this prospective, randomized study were to evaluate the efficacy and tolerability of the short-term use of medium-chain triglyceride/long-chain triglyceride (MCT/LCT) fat emulsions, and to compare the hematologic and biochemical effects of MCT/LCT fat emulsions with LCT fat emulsions in gastrointestinal (GI) tract cancer patients following surgery. Thirty patients with GI tract cancer requiring total parenteral nutrition (TPN) were equally randomized to receive MCT/LCT or LCT emulsions for 7 days. After 7 days, no sign of complications directly related to administration of fat emulsions was observed and there were no marked differences in anthropometry, length of hospital stay, and surgical complication rates between the two groups. However, MCT/LCT significantly improved plasma prealbumin concentration (p = 0.005). Changes in complements C3 and C4, total lymphocyte count, and immunoglobulins after TPN were not significantly different between the groups. Serum triglyceride and cholesterol levels remained constant. The serum insulin level in the MCT/LCT group was higher than in the LCT group (p = 0.048). Our data revealed that MCT/LCT fat emulsions significantly enhanced nutritional status in patients with GI tract cancer, indicated by higher prealbumin levels, which might be partially due to the higher circulating insulin levels in the MCT/LCT group. |
本系統中英文摘要資訊取自各篇刊載內容。