256 2004 3 4 256-260 Journal of Digestive Surgery,2004,3 (4) :256-260 : 1671-4555(2004) 04-0256 - 05 Ξ ΞΞ ( TPN), ( ) 4, 7 d,,tpn 1 4 7 d, A KBR( ) AL T AST TBIL 7 d (50 % vs 0 %), 7 d AL T AST TBIL,A KBR TPN 1 d, 7 d 1 4 d AL T TPN TPN,MCT/ TPN AL T TPN TPN,, TPN, R657. 3 A Influence of total parenteral nutrition containing different fat emulsion on hepatic function in rats after liver trans2 plantation Liu Lidong, Ma Zhengwei, Li Kun, Zhang Yujun, Chen Lijun, Dong Jiahong. Institute of Hepa2 tobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038 Abstract Objective To study the influence of glucose with different kinds of fat emulsions or without fat emulsion on hepatic function after liver transplantation in rats. Methods A model of TPN in rats with liver transplantation with modified tube and retainer was established. Seventy2two rats after liver transplantation were assigned to four groups containing 18 pairs of rats each according to the different ener2 gy sources. Rats in group were given and glucose. Group and received plus glucose and plus glucose, respectively. Glucose was the only energy source in Group. The specimen of blood was obtained on day 1, 4, and 7 after TPN. A KBR, serum AL T, AST, and TBIL were determined. Animal survival was recorded during the experimental period. Results Compared with other groups, serum AL T and AST levels in Group were decreased slowly. While TBIL level was ele2 vated gradually. Though A KBR was increased on day 1 after TPN, it declined gradually and was signifi2 cantly lower than that in normal control group on day 7. Mortality rate of rats in group was 50 % dur2 ing the experimental period. In the three fat emulsions groups, the serum AL T, AST, TBIL and A KBR recovered to normal level 7 days after TPN. No animal death due to TPN was found in fat emulsion groups. Serum levels of AL T and AST in Group were more significantly lower than those in Group. AL T and AST in Group were significantly decreased when compared with Group, especially during the early period of TPN. Conclusions TPN containing fat emulsion is safe and ef2 fective in rats with liver transplantation, and seems to be the best choice of fat emulsion, while TPN with kilocalorie supplemented by only is not helpful for improving liver function. Key words liver transplantation rats total parenteral nutrition fat emulsion liver function Ξ (No. 30228030) ; : 400038 ( ΞΞ 266100 141 ) :,, ; :023-68754168 ; Fax :023-65317637 ; Email :jhdong @hbsky. com. cn
, 1 TPN ( ml), ( TPN) 1,2,, 1 1. 1 1. 4 SD 162,, 220240 g, 2 NC 12 h, TC 6 h, TPN, 2 h, 6 (NC), 6 ( TC) TPN 1. 5 : ( ) ( ) 1. 5. 1 1 4 7 d ( ) (,struc2, tured triglyceride),,,, 1 4 7d, 6,, 6h TPN, 1. 5. 3 A KBR 1 ml 1 ml 10 % HClO 4 1. 2 3 XTS24A : ; min, - 20, SSW23 : ; A KBR (AcAc) 2 ( 2HB), : ; YBWZ212 : A KBR = AcAc/ 2HB ;Beckman CX27 1. 6 :USA 20 % 20 % : ; 20 % : ;10 % 182F : 2 1. 3 TPN TPN 2. 1 ; 4 d 2 3,4 TPN,7 d 3 7 d, 741. 8 KJ kg - 1 d - 1,1. 5 g kg - 1 d - 1, = 494. 5 KJ 1 g, 2. 2 ( 24) 6 4,8. 9 ml kg - 1 h - 1 24 h : 6 h AL T AST, 1,. 257 50 % 266 264. 3 263 440 10 % 0 8. 7 14 14 20 % 188 181 177 0 10 % 536 536 536 536 10 % 35 35 35 35 10 % 15 15 15 15 10 % 10 10 10 10 10 10 10 10 2 2 2 2 10 10 10 10 1 070 1 070 1 070 1 070-80 1. 5. 2 AL T AST, TBIL, 3 000 r / min 10 min ; K 2 CO 3 (5 mol/ L) 40 l, p H 7 ;3 000 r / min 10 gx s, SPSS 10. 0 ( P < 0. 05), AL T, 20
258,. (1 061/ 50) TPN AL T,,7 d,4 d,7, AL T,7 d AST d 6 h A KBR 0. 6,, TPN 1 d,4 d TPN,1 d 0. 7,,7 d, AST,7 d TPN 7 d A KBR, TBIL 6 h, TPN,4 d, 2 TPNALT ( IU) 50. 00 11. 21 1061. 83 150. 25 3 274. 00 35. 00 3 a 50. 00 11. 21 1061. 83 150. 25 3 173. 33 24. 95 3 b 50. 00 11. 21 1061. 83 150. 25 3 322. 40 35. 00 3 c 50. 00 11. 21 1061. 83 150. 25 3 467. 60 120. 50 3 c 139. 17 32. 84 3 a 70. 00 15. 52 b 97. 50 10. 13 3 c 323. 50 38. 42 3 d 57. 00 8. 22 a 49. 83 5. 56 a 49. 60 4. 88 a 268. 67 35. 64 3 b 3 :NC P < 0. 05 ; :TC P < 0. 05 ; 3 TPNAST ( IU) 436. 33 69. 57 623. 00 185. 23 3 653. 00 78. 42 3 a 409. 00 31. 22 a 436. 33 69. 57 623. 00 185. 23 3 717. 50 109. 34 3 a 405. 80 53. 10 a 423. 60 38. 55 a 421. 67 118. 32 a 436. 33 69. 57 623. 00 185. 23 3 654. 00 125. 36 3 a 501. 50 52. 64 b 414. 20 37. 77 a 436. 33 69. 57 623. 00 185. 23 3 1030. 00 253. 22 3 b 641. 00 72. 17 3 c 689. 67 109. 00 3 b 3 :NC P < 0. 05 ; :TC P < 0. 05 ; 4 TPNTBIL (mol/ L) 2. 07 0. 35 2. 93 0. 57 3 3. 08 0. 50 3 a 2. 15 0. 36 a 2. 07 0. 35 2. 93 0. 57 3 2. 80 0. 52 3 a 2. 06 0. 32 a 2. 07 0. 35 2. 93 0. 57 3 2. 46 0. 49 a 2. 08 0. 24 a 2. 16 0. 25 a 1. 88 0. 42 a 2. 08 0. 32 a 2. 07 0. 35 2. 93 0. 57 3 2. 54 0. 40 a 2. 83 0. 63 3 b 3. 81 0. 31 3 b 3 :NC P < 0. 05 ; :TC P < 0. 05 ; 2. 3 A KBR ( 5) 5 TPNAKBR 0. 83 0. 07 0. 56 0. 12 3 0. 76 0. 32 a 0. 83 0. 07 0. 56 0. 12 3 0. 74 0. 11 a 0. 73 0. 11 a 0. 84 0. 16 a 0. 83 0. 07 0. 56 0. 12 3 0. 70 0. 09 3 a 0. 76 0. 12 a 0. 83 0. 07 0. 56 0. 12 3 0. 69 0. 08 3 a 0. 75 0. 07 a 0. 76 0. 04 a 0. 80 0. 17 a 0. 82 0. 75 a 0. 44 0. 073 3 b 3 :NC P < 0. 05 ; :TC P < 0. 05 ;
3,. 259, 3. 1 TPN 7,,,, AL T,, (1 4 d), 2,5,,, ;7d,, 6, MCT C8 TPN 0, C10 0 MCFA, 7 7d LCFA, MCFA (50 %),, ;, LCFA ; TPN,, TPN ( ), LCFA 3. 2 TPN, :, MCT/, 6 h AL T AST TB IL,,, AL T, 20 LCFA, C18 (1 061/ 50) ; AST, 2,,TPN 1 d, TPN (7 d), TPN AL T AST TB IL,,,4 d TB IL,,7 d AL T AST,GL U AL T AST,7 d, ; GL U TPN TB IL,4 d,,7 d A K2? BR 6 h 0. 6, MCT, TPN,A KBR,1 d 0. 7, MCT ; TPN 4 d A KBR MCFA,,, MCT, MCT TPN, TPN 3 MCFA LCFA 9,,,, TPN TB IL 8
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