臺灣博碩士論文加值系統

中文摘要
血脂的異常或代謝障礙，是心血管疾病重要的醫療照護指標。而飲食中脂肪的攝取量與種類，則會影響血脂質之代謝，與心血管疾病有極大之關連。本研究以交叉試驗設計進行，在插鼻胃管餵食的老年人隨機分成兩組，分別給予短期二週的高含量之單元不飽和脂肪酸以及多元不飽和脂肪酸飲食，共有10位志願者 ( 4位男性和6位女性，平均年齡為 74±2.0，身體質量指數 18.3±1.5 kg/m2 ) 參與本研究，每日提供受試者1800 大卡熱量。本研究介入飲食的脂質含量占總熱量的43% ；其中一組給予高含量多元不飽和脂肪酸，占脂質含量的52%；另一組給予高含量單元不飽和脂肪酸，占脂質含量的42%；之後再交叉供應。結果顯示，經二週的飲食介入後，其血漿中總膽固醇、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇、三酸甘油酯、高密度脂蛋白元A1及低密度脂蛋白元B等含量變化，無顯著性差異。顯示當給予相同熱量、相同脂肪攝取量時，高含量單元或高含量多元不飽和脂肪酸飲食的介入，對於管灌老人之血脂的代謝並無顯著影響與差異。但是，在高含量單元不飽和脂肪酸的飲食介入組，血漿中有較低的總膽固醇、三酸甘油酯、低密度脂蛋白膽固醇、低密度脂蛋白元B和較高的高密度脂蛋白元A1濃度的趨勢；另外，在高含量多元不飽
和脂肪酸的飲食介入組，則有較低的收縮壓和舒張壓之血壓值趨勢。
關鍵詞: 單元不飽和脂肪酸、多元不飽和脂肪酸、交叉試驗、
血脂質、心血管疾病

Abstract
Dietary fats on the risk of cardiovascular disease (CVD) have been revealed by their effects on low density cholesterol (LDL). The diagnosis of blood lipid disorders, or dyslipidemia, is a key component to the standard of medical care for patients with cardiovascular disease. This is a cross-over study to evaluate two weeks of dietary supplementation with poly- or monounsaturated fatty acids on blood lipids of Nasogastric Tube-Feeding (NG-feeding) elderly patients. Ten elders (4 men and 6 women, mean age 74.0±2.0, body mass index 18.3±1.5 kg/m2) were involved in this study and supplemented with a 1800 kcal diet a day. The dietary supplementation contained 43% energy of fat and rich either with polyunsaturated fatty acids (PUFA；52% of Fat) or monounsaturated fatty acids (MUFA；42% of Fat). The effects on total cholesterol, LDL cholesterol, HDL cholesterol, triglycerol, apolipoprotein A-1 and B levels by two diets were similar. This study revealed that isocaloric diets rich in MUFA or PUFA had no different effects on blood lipids for elderly patients in two weeks of duration. However, as compared with PUFA rich diet treatment, subjects of MUFA rich diet had lower total cholesterol, LDL cholesterol, triglycerol, apolipoprotein B levels and higher apolipoprotein A-1 levels on blood lipids. In addition, subjects of PUFA rich diet had lower systolic and diastolic blood pressure.
Keywords: monounsaturated fatty acid, polyunsaturated fatty acid, cross-over study, blood lipid, cardiovascular disease

目 錄
頁次
表次…………………………………………………………………….. I
圖次……………………………………………………………………. II
中文摘要……………………………………………………………… III
英文摘要……………………………………………………………… V
壹、前言………………………………………………………………. 1
貳、文獻整理…………………………………………………………. 4
一、心血管疾病與血脂質的相關性……………………………… 4
二、血脂質………………………………………………………… 7
三、血脂質的代謝………………………………………………… 11
(一) 三酸甘油酯的運送……………………………………… 11
(二) 膽固醇的運輸…………………………………………… 16
四、血脂質的正常值……………………………………………… 18
五、影響血脂質代謝的營養因子………………………………… 21
(一) 單元不飽和脂肪酸……………………………………… 23
(二) 多元不飽和脂肪酸……………………………………… 24
(三) 飽和脂肪酸……………………………………………… 25
參、研究目的…………………………………………………………. 26
肆、材料與方法………………………………………………………. 27
一、研究設計……………………………………………………… 27
二、研究對象……………………………………………………… 28
三、研究方法……………………………………………………… 30
(一) 試驗流程………………………………………………… 31
(二) 熱量設計………………………………………………… 32
(三) 基本資料………………………………………………… 34
(四) 飲食設計………………………………………………… 36
(五) 營養評估………………………………………………… 39
(六) 統計方法………………………………………………… 41
伍、結果………………………………………………………………. 42
一、基本資料及體位測量………………………………………… 42
二、血液生化值…………………………………………………… 44
三、心血管疾病的危險因子……………………………………… 46
四、血壓值…………………………………………………………. 48
陸、討論………………………………………………………………. 50
柒、結論………………………………………………………………. 57
捌、參考文獻…………………………………………………………. 58
附錄一 同意書………………………………………………………... 76
附錄二 問卷調查……………………………………………………... 78
附錄三 飲食紀錄……………………………………………...……… 80
附錄四 實驗紀錄……………………………………………………... 81
附錄伍 血液生化測量之標準範圍…………………………………... 82

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