Efficacy of structured triglycerides in parenteral nutrition in elderly patients with acute biliary tract infection / 中华老年医学杂志

ABSTRACT

Objective To investigate the safety and efficacy of structured triglycerides in parenteral nutrition in elderly patients with acute biliary tract infection.Methods 62 elderly patients with acute biliary tract infection under conservative therapy were randomly divided into structured triglycerides (ST) group and medium-chain triglycerides plus long-chain triglycerides (MCT/LCT) group.Patients underwent parenteral nutrition for 5 days.Levels of hepatic enzymes,blood triglycerides,nitrogen balance,fasting blood insulin and glucose were compared between the two groups after 5 days of parenteral nutrition.Results There were no significant differences in levels of hepatic enzymes,blood triglycerides and fasting blood glucose between ST group and MCT/LCT group.Plasma total bilirubin (T-Bill) levels were increased in the two groups,and T-Bill level dropped faster in the ST group than in the MCT/LCT group after 7 days of parenteral nutrition(P＜ 0.05).The difference in total cholesterol level dropping was significant between ST group and MCT/ LCT group (P＜0.05).The cumulative nitrogen balance for 5 days had significant difference between ST and MCT/LCT groups [(4.7-±-2.2) g vs.(2.8±0.7) g,P＜0.05].STG group versus MCT/LCT group had less fluctuation of fasting blood insulin level after 1,4 and 7 days of parenteral nutrition.Conclusions In the acute phase of biliary tract infection in elderly patients,ST-based parenteral nutrition can provide energy and help maintain nitrogen balance,with a little fluctuation of fasting blood insulin level.Short-term nutritional support may have better tolerance in the liver and has little effect on the change of hepatic enzymes.