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目的：通过比较结构脂肪乳剂与长链脂肪乳剂在肝硬化病人中的产热及代谢效应，以评估结构脂肪乳剂在肝硬化病人中的应用价值。方法：选择１６例经病理证实为肝硬化病人作为研究对象，进行随机交叉研究。第一组７例病人分别连续输注２０％Ｉｎｔｒａｌｉｐｉｄ或２０％Ｓｔｒｕｃｔｏｌｉｐｉｄ４ｈ（０．２５ｇＴＧ／ｋｇ·ｈ－１）。第二组９例病人分别连续输注上述脂肪乳剂和葡萄糖混合液６ｈ（０．１７ｇＴＧ／ｋｇ·ｈ－１及０．１３ｇ葡萄糖／ｋｇ·ｈ－１）。采用间接测热法测定机体静息能量消耗及产热作用。应用反式高效应液相及气相色谱分别测定研究前、后血浆游离脂肪酸、β－羟基丁酸盐、３－羟基脂肪酸和血浆二羧酸浓度。结果：所有病人均有较好的耐受性。输注脂肪乳剂后，各组病人的静息能量消耗均明显高于基础值，结构脂肪乳剂组病人产热明显高于应用长链脂肪乳剂组。两组病人血浆甘油三酯及游离脂肪酸浓度增加程度相似，但结构脂肪乳剂组病人血浆β－羟基丁酸盐浓度、血浆二羧酸（ＤＣ１０）及血浆３－羟基脂肪酸（３－ＯＨＣ８）浓度均明显高于长链脂肪乳剂组。联合应用葡萄糖时，上述各指标均明显低于单独输注脂肪乳剂组。结论：结构脂肪乳剂在肝硬化病人中水解、氧化及产热作用明显高?
OBJECTIVE: To evaluate the value of structural fat emulsion in patients with cirrhosis by comparing the thermogenic and metabolic effects of structured and long chain fat emulsions in cirrhotic patients. Methods: Sixteen patients with cirrhosis confirmed by pathology were selected as study subjects and randomized crossover study was conducted. The first group of 7 patients received continuous infusion of either 20% Intralipid or 20% Structolipid 4h (0.25 gTG / kg · h-1) respectively. The second group of 9 patients were continuous infusion of the above-mentioned fat emulsion and glucose mixture 6h (0.17gTG / kg · h-1 and 0.13g glucose / kg · h-1). Indirect calorimetry was used to measure body resting energy expenditure and thermogenesis. The concentrations of plasma free fatty acid, β-hydroxybutyrate, 3-hydroxy fatty acid and plasma dicarboxylic acid before and after the study were determined by trans-high performance liquid chromatography and gas chromatography respectively. Results: All patients have better tolerability. After infusion of fat emulsion, the resting energy expenditure of patients in each group were significantly higher than the baseline values, and the patients with structured fat emulsion had significantly higher heat production than those using long-chain fat emulsion. Plasma triglyceride and free fatty acid concentrations increased similarly in both groups, but plasma beta-hydroxybutyrate concentrations, plasma DCs and 3-OHC8 concentrations in the structured emulsion group were all significantly higher Significantly higher than the long-chain fat emulsion group. The combination of glucose, the above indicators were significantly lower than the lipid emulsion alone infusion group. Conclusion: The structure of lipid emulsion in patients with liver cirrhosis hydrolysis, oxidation and heat production was significantly higher?