Effects of lipid emulsion on parenteral nutrition associated liver disease in old tumor patients: a retrospective study
10.3760/cma.j.issn.1674-635X.2010.01.007
- VernacularTitle:脂肪乳剂对老年肿瘤患者肠外营养相关肝功能损伤影响的回顾性分析
- Author:
Renying XU
;
Yanping WAN
;
Chengdi SHAN
;
Wanrong SHEN
;
Zhiqi CHEN
;
Xiaomin ZHANG
;
Liping LU
- Publication Type:Journal Article
- Keywords:
Elderly;
Tumor;
Parenteral nutrition associated liver disease;
Lipid emulsion
- From:
Chinese Journal of Clinical Nutrition
2010;18(1):24-28
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of lipid emulsion on parenteral nutrition associated liver dis ease (PNALD) in old tumor patients. Methods A retrospective study was performed with 402 patients in Renji Hospital from January 2003 to December 2008. Patients were retrieved according to the following criteria: (1)age ≥60 years; (2) confirmed diagnosis of tumor, had no evidence of metastasis, and tumor was completely resected before receiving parenteral nutrition; (3) liver and kidney function was in normal range before receiving parenteral nutrition; (4) parenteral nutrition days ≥7; and (5) parenteral nutrition was infused in "all in one" bag via central venous. Patients with history of viral hepatitis or died in parenteral nutrition episode were excluded. These 402 patients aged (71.7 ±6.8) years and the average parenteral nutrition time was (10. 2 ±5.9) (range, 7-61 )days. In 311 patients (77.4％), non-protein calorie was obtained from carbohydrate and lipid and 91 patients (22. 6％ ) just obtained non-protein calorie from carbohydrate. Results The total prevalence of PNALD was 15.2％ (61/402). The prevalence of PNALD was 8.8％ (8/91) in patients receiving parenteral regiment without lipid and 17.0％ (53/311) in patients receiving parenteral nutrition with lipid, and there was no significant difference in prevalence of PNALD between two groups (χ2 = 3.72, P = 0.07 ). Lipid type and amount showed no significant effects on PNALD ( P ＞ 0.05 ). The fever days ( P ＜ 0. 001 ), baseline level of alanine transaminase (P ＜0. 001 ) and γ-glutamyltransferase (P ＜0. 001 ) were risk factors for liver injury by logistic regression. Conclusion Lipid emulsion can be safely used in old tumor patients without affecting the occurrence of PNALD.
