Apolipoproteine und lipide im serum von schwerverletzten in abhängigkeit von der ernährung eine pilotstudie

In 10 patients with polytrauma and 2 patients with sepsis a relation of the severety of trauma and the change of lipoproteins has been found. Cholesterol and triglycerides as well as apolipoproteins A-I and B decrease significantly in the first days after the injury. During the following rise of cholesterol and triglycerides apolipoprotein A-I increases also to a concentration of lower normal range; apolipoprotein B remains lowered. Apolipoprotein C-III₂ is determined in 3 patients and is increased. The concentration of apolipoprotein A-I decreases in three of five patients, who had parenteral fat administration. Apolipoprotein B increases during fat administration. The following fat free parenteral nutrition causes a decrease of apolipoprotein B again. The composition of lipoproteins is similarly changed in 2 patients with sepsis. The apolipoproteins as well as the lipids decrease more in patients who died later than in the case of reconvalescence, in which the increase of concentrations of lipids and apolipoprotein B may be accelerated with parenteral nutrition. Apolipoprotein A-I reacts variably, A-II is lowered.