Nitrogen Balance During Total Parenteral Nutrition Glucose vs. Fat
Nitrogen Balance During Total Parenteral Nutrition Glucose vs. Fat
复制标题
全肠外营养期间的氮平衡葡萄糖与脂肪
作者：
J. Nordenström;D. Elwyn;Pat Martin;Y. Carpentier;A. Robin;J. Kinney
氮平衡和能量消耗测定18创伤和/或脓毒症患者和5个耗尽患者在不同的饮食条件。全胃肠外营养（TPN）完全以高渗葡萄糖溶液（葡萄糖系统）或半葡萄糖半静脉脂肪乳剂（脂质系统）的形式给予非蛋白质能量。在急性病患者中，从5%葡萄糖改为TPN导致氮平衡迅速改善至维持水平。给予葡萄糖或脂质系统的患者之间没有显著差异。五名耗尽的患者交替给予脂质和葡萄糖系统，共19个一周的周期。两种饮食均达到了高度正的氮平衡，80 mg N/kg/天。饮食之间没有显着差异，从一种饮食切换到另一种饮食后没有适应期。在可比的静脉饮食中，急性病患者的葡萄糖、甘油、甘油三酯、胰岛素和胰高血糖素的血浆浓度高于消耗患者。这项研究表明，在中度创伤或感染以及营养不良的患者中，脂质和葡萄糖系统的氮节省效果是相似的。在选择静脉支持的脂质和葡萄糖系统时，氮平衡以外的因素更为重要。
Nitrogen balance and energy expenditure were measured in 18 traumatized and/or septic patients and five depleted patients during different dietary conditions. Total parenteral nutrition (TPN) was given with nonprotein energy entirely as hypertonic glucose solutions (glucose system) or as half glucose-half intravenous fat emulsion (lipid system). In acutely ill patients, the change from 5% dextrose to TPN resulted in a prompt improvement of nitrogen balance to maintenance levels. There were no significant differences between patients given the glucose or lipid system. The five depleted patients were given the lipid and glucose systems alternately for a total of 19 one-week periods. A highly positive N balance, 80 mg N/kg day, was attained on both diets. There was no significant difference between diets and no period of adaptation after switching from one diet to the other. On comparable intravenous diets, the acutely ill patients had higher plasma concentrations of glucose, glycerol, triglycerides, insulin, and glucagon than did the depleted patients. The study shows that the nitrogen-sparing effects of the lipid and the glucose systems are similar in moderately traumatized or infected as well as in malnourished patients. Factors other than nitrogen balance are of greater importance when choosing between the lipid and the glucose system for intravenous support.
全肠外营养期间增加葡萄糖摄入量会增加创伤和败血症时去甲肾上腺素的排泄。
DOI：
10.1111/j.1475-097x.1981.tb00919.x
发表时间：
1981
期刊：
Clinical physiology (Oxford, England)
影响因子：
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作者：
Nordenström,J;Jeevanandam,M;Elwyn,DH;Carpentier,YA;Askanazi,J;Robin,A;Kinney,JM
通讯作者：
Kinney,JM