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1.新疆医科大学第六附属医院药学部,乌鲁木齐 830002
2.新疆医科大学第六附属医院重症医学科,乌鲁木齐 830002
主管药师,硕士。研究方向:临床药学。电话:0991-2615177。E-mail:zhangrui9346@163.com
主任药师,硕士。研究方向:临床药学、民族药药理学。电话:0991-2615177。E-mail:jinxiaoyue0112@163.com
纸质出版日期:2023-02-28,
收稿日期:2022-07-03,
修回日期:2023-01-12,
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张瑞,郑军,杨浩等.个体化肠外营养支持对比预混肠外营养配方对急性肾损伤患者肝功能的影响 Δ[J].中国药房,2023,34(04):457-460.
ZHANG Rui,ZHENG Jun,YANG Hao,et al.Effects of individualized parenteral nutrition versus pre-mixed parenteral nutrition on liver function of patients with acute kidney injury[J].ZHONGGUO YAOFANG,2023,34(04):457-460.
张瑞,郑军,杨浩等.个体化肠外营养支持对比预混肠外营养配方对急性肾损伤患者肝功能的影响 Δ[J].中国药房,2023,34(04):457-460. DOI: 10.6039/j.issn.1001-0408.2023.04.14.
ZHANG Rui,ZHENG Jun,YANG Hao,et al.Effects of individualized parenteral nutrition versus pre-mixed parenteral nutrition on liver function of patients with acute kidney injury[J].ZHONGGUO YAOFANG,2023,34(04):457-460. DOI: 10.6039/j.issn.1001-0408.2023.04.14.
目的
2
比较个体化肠外营养支持对比预混肠外营养配方对急性肾损伤(AKI)患者肝功能的影响。
方法
2
选择2021年1月-2022年3月我院重症医学科收治的97例AKI患者,按随机数字表法分为商业预混多腔袋(MCB)组(48例)和个体化全合-营养液(COM)组(49例)。两组患者及时给予纠正可逆性病因的常规治疗,待液体复苏成功或小剂量血管活性药物血流动力学稳定后48 h内开始肠外营养支持治疗。MCB组患者给予脂肪乳氨基酸(17)葡萄糖(11%)注射液1袋,静脉输注,每日1次。COM组患者给予中/长链脂肪乳注射液(C8~24Ve)0.5~0.8 g/kg+复方氨基酸18AA-Ⅶ 1.0~1.2 g/kg+葡萄糖注射液1.5~2.5 g/kg+注射用水溶性维生素1支+脂溶性维生素注射液(Ⅱ)10 mL+多种微量元素注射液(Ⅱ)10 mL+个体化补充氯化钠、氯化钾,糖脂比5∶5、热氮比100∶1。两组患者疗程均为7 d。观察两组患者治疗前后的肝功能异常占比、肝功能指标[丙氨酸转氨酶(ALT)、总胆红素(TBIL)、天冬氨酸转氨酶(AST)]、白蛋白(ALB)、白细胞介素6(IL-6)及C反应蛋白(CRP)水平。
结果
2
治疗后,MCB组患者的肝功能异常占比、ALT、AST、CRP水平均显著高于同组治疗前,且MCB组患者的肝功能异常占比、ALT、CRP水平均显著高于COM组(
P
<0.05);COM组患者治疗前后肝功能异常占比、ALT、AST、TBIL、CRP水平比较,差异均无统计学意义(
P
>0.05)。
结论
2
个体化肠外营养支持治疗可减少AKI患者肝损伤的发生,改善患者的营养状况。
OBJECTIVE
2
To compare the effects of individualized parenteral nutrition versus pre-mixed parenteral nutrition on liver function of patients with acute kidney injury (AKI).
METHODS
2
Totally 97 AKI patients in the intensive care unit of our hospital from January 2021 to March 2022 were collected and randomly divided into pre-mixed multi-chamber bag (MCB) group (48 cases) and compounded parenteral nutrition (COM) group (49 cases). The patients in both groups were given routine treatment to correct the reversible cause in time, and parenteral nutrition support treatment was started within 48 hours after the fluid resuscitation was successful or the hemodynamics of low-dose vasoactive drugs were stable. MCB group was given one bag of Fat emulsion amino acid (17) glucose (11%) injection, intravenous infusion, once a day; COM group was given Medium/long chain Fat emulsion injection (C8-24Ve) 0.5-0.8 g/kg+Compound amino acid 18AA-Ⅶ 1.0-1.2 g/kg+Glucose injection 1.5-2.5 g/kg+one Water soluble vitamin injection+Fat-soluble vitamin injection (Ⅱ) 10 mL+Multiple trace element injection (Ⅱ) 10 mL+individualized supplement of sodium chloride and potassium chloride, with a ratio of glucose to lipid of 5∶5 and a ratio of heat to nitrogen of 100∶1. The treatment course of both groups lasted for 7 days. The percentage of abnormal liver function, the levels of liver function indexes [alanine aminotransferase (ALT), total bilirubin (TBIL), aspartate transaminase (AST)], albumin (ALB), interleukin-6 (IL-6) and C-reactive protein (CRP) were observed in 2 groups before and after treatment.
RESULTS
2
After treatment, the ratio of liver dysfunction, the levels of ALT, AST and CRP in MCB group were significantly higher than before treatment; the ratio of liver dysfunction, the levels of ALT and CRP in MCB group were significantly higher than COM group (
P
<0.05). There were no statistical significance in the ratio of liver dysfunction, the levels of ALT, AST, TBIL and CRP in COM group before and after treatment (
P
>0.05).
CONCLUSIONS
2
Individualized parenteral nutrition support treatment can reduce the occurrence of liver injury and improve the nutritional status of AKI patients.
急性肾损伤肝损伤个体化肠外营养肝功能
liver injuryindividualized parenteral nutritionliver function
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