中文摘要：

目的研究含不同脂肪乳剂（fatemulsion，FE）的肠外营养（parenteralnutrition，PN）对肝移植大鼠脂代谢及氮平衡影响。方法建立肝移植大鼠模型，随机分为葡萄糖组（GLU组，不使用FE）、结构脂肪乳剂组（STG组）、长链脂肪乳剂组（LCT组）、中长链脂肪乳剂组（MCT／LCT组）4组，于术后6h开始给予单糖或单糖与不同类型FE联合供能的PN，同时设立假手术对照组（SO组）。于PN后1、4、7d收集标本，检测氮平衡、血脂、肝组织脂类的变化。结果与3种脂肪乳剂组相比，GLU组7d内TG和LDL-C逐渐升高，HDL-C持续降低，7d时呈负氮平衡，7d动物死亡率为50％。7d内3种脂肪乳剂组血清TG、TC、LDL-C恢复正常水平，与SO组比较差异无统计学意义；HDL-C水平持续升高，7d内均达到正氮平衡；3种脂肪乳剂组均无PN所致死亡。4d时STG组先于LCT、MCT／LCT两组转为正氮平衡，7d内STG组氮平衡显著高于LCT、MCT／LCT两组，MCT／LCT组氮平衡高于LCT组。结论单糖PN显著影响受体脂代谢，导致大鼠死亡率增高；单糖不宜作为PN的惟一能源；而含FE的PN不会导致肝脏的脂肪沉积，对受体脂代谢没有明显影响。相反，能改善肝移植受体的氮平衡，有利于动物的长期存活，可用于肝移植后的营养支持。STG的作用优于MCT／LCT和LCT。

英文摘要：

Objective To study the influence of parenteral nutrition （PN） containing different kinds of fat emulsion （FE） on nitrogen balance and lipid metabolism in rats after liver transplantation. Methods Rats with liver transplantation were randomly divided into 5 groups, ie, glucose group （ GLU group, without FE）, structured triglyceride （STG） group （ STG group）, long-chain triglycerides （LCT） group （ LCT group）, medium-chain triglyeeride/long-ehain triglyeerides （MCT/LCT） group （MCT/LCT group） and sham operation group （SO group）. All groups were energized with monosaceharide and monosaceharide combined with different kinds of PN at postop- erative 6 hour. The specimen of blood, urine, and liver tissues were obtained at days 1, 4 and 7 after PN for determining changes of nitrogen balance, blood fat and liver tissue lipid. Results Compared with STG, LCT and MCT/LCT groups, GLU group had gradual increase of TG and LDL-C within seven days, with negative nitrogen balance and mortality rate of 50% at day 7. Within seven days, serum TG, TC and LDL-C of STG, LCT and MCT/LCT groups recovered to normal, with＇insignificant difference compared with SO group. Serum HDL-C was continually increased and reached positive nitrogen balance within 7 days. There was no death caused by PN in STG, LCT and MCT/LCT groups. STG group reached positive nitrogen balance at day 4 prior to LCT and MCT/ LCT groups. The nitrogen balance in STG group within 7 days was significantly higher than that in LCT and MCT/LCT groups, with higher nitrogen balance of MCT/LCT group than that of LCT group. Conclusions Monosaccha- ride PN can disturb lipid metabolism and lead to increase of mortality rate of rats and hence is not suitable to be as sole source of PN. While PN containing FE is safe and effective in improving animal survival and nitrogen balance and can be used as nutritional support after liver transplantation. STG is the best among 3 kinds of FE.