肠胃外营养(PN)是一种维持生命的方法,可为无法接受口服或肠内营养的患者提供足够的营养。PN通常含有大量和微量营养素的混合物,尽管脂质成分已被确定为肝病的担忧。因此,需要对家庭PN(HPN)患者的静脉内脂肪乳剂(ILE)处方实践以及不同的脂质PN是否会改变肝功能检查(LFTs)进行研究.
方法:对美国105名成人HPN患者进行为期6个月的随机样本的每月LFTs进行回顾性研究。患者接受橄榄油/大豆油(n=53,Clinolipid),混合ILE(n=39,SMOF脂质),大豆油(SO;n=4,内脂),或无(n=7)。监测的LFTs为碱性磷酸酶(ALP),丙氨酸转氨酶(ALT),天冬氨酸转氨酶(AST),和总胆红素(TBili)。
结果:组间基线LFT无差异(所有,p>0.25,η2<0.04),年龄也没有差异,身体质量指数,PN的日子,或平均PN体积(所有,p>0.36,η2<0.05)。ILE类型和时间之间没有显著的相互作用(所有p>0.64,ηp2<0.03),ILE类型无影响(所有p>0.60,ηp2<0.03),在LFTs方面没有时间影响(所有p>0.69,ηp2<0.01)。六个月内的平均LFT在ILE类型之间也没有差异(所有p>0.30,η2<0.04)。
结论:这些研究结果表明,患者大多被处方混合或ILEPN含有一个以上的脂质来源,并且长期HPN患者的不同ILE在6个月内没有改变LFT。
Parenteral nutrition (PN) is a life-sustaining method to provide adequate nutrients to patients unable to receive oral or enteral nutrition. PN typically contains a mixture of macro- and micro-nutrients, although the lipid composition has been identified as a concern for liver disease. Therefore, the study of the intravenous lipid emulsion (ILE) prescribing practices in home-based PN (HPN) patients and whether differing lipid PN alters liver function tests (LFTs) is needed.
METHODS: A retrospective study of monthly LFTs from a random sample of 105 adult HPN patients in the U.S. over a 6-month period was conducted. Patients were receiving olive oil/soy oil (n = 53, Clinolipid), mixed ILE (n = 39, SMOF Lipid), soy oil (SO; n = 4, Intralipid), or none (n = 7). LFTs monitored were alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST), and total bilirubin (T Bili).
RESULTS: No differences were observed in baseline LFTs across groups (all, p > 0.25, η2 < 0.04), nor were there differences in age, body mass index, days of PN, or mean PN volume (all, p > 0.36, η2 < 0.05). There were no significant interactions between ILE type and time (all p > 0.64, ηp2 < 0.03), no effect of ILE type (all p > 0.60, ηp2 < 0.03), and no effect of time (all p > 0.69, ηp2 < 0.01) in terms of LFTs. Average LFTs over six months were also not different between ILE types (all p > 0.30, η2 < 0.04).
CONCLUSIONS: These findings suggested that patients were mostly prescribed mixed or ILE PN containing more than one lipid source and that differing ILEs in long-term HPN patients did not alter LFTs over a six-month period.