含胆酸的肠内营养在肝硬化大鼠肝切除术后的应用  

Application of posthepatectomy enteral nutrition with cholic acid in cirrhotic rats

作　　者：罗时敏[1] 谭卫民[1] 罗建威[1] 常颖智[1] 

机构地区：[1]广州市第一人民医院综合外科,510180

出　　处：《中华普通外科学文献（电子版）》2009年第3期24-27,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广州市医药卫生科技项目(2007-YB-011);广东省医学科学技术研究基金项目(A2007490)

摘　　要：目的探讨含胆酸的肠内营养在肝硬化大鼠肝切除术后的应用。方法24只肝硬化大鼠随机分为术前组、肝切除术后1d组、肝切除术后行不含胆酸的肠内营养5d组、肝切除术后行含胆酸的肠内营养5d组,各6只。并选择6只正常大鼠作为正常对照组,测大鼠肝功能、炎症反应、脂质过氧化、肝组织白蛋白(ALB)mRNA的表达和肝组织Ki67蛋白的表达。结果与不含胆酸的肠内营养5d组比较,含胆酸的肠内营养5d组血清AST、ALT、ALP显著下降(P<0.05),血清ALB、IGF-1显著升高(P<0.05),血清IFN-γ、TNF-α、MDA显著下降(P<0.05),血清SOD活性显著升高(P<0.05),肝组织ALBmRNA表达显著升高(P<0.05),肝组织Ki67蛋白表达显著升高(P<0.05)。结论含胆酸的肠内营养可以加快肝硬化大鼠肝切除术后肝功能的恢复,减轻炎症反应和脂质过氧化损伤,促进肝脏蛋白合成和残肝再生。Objective To explore the application of posthepatectomy enteral nutrition（EN） with cholic acid in cirrhotic rats. Methods Six normal rats severed as normal group, twenty-four rats with hver cirrhosis were randomly divided into pre-operation group（n=6）, post-operation I day group（n=6）, post-operation EN without cholic acid 5 day group（n=6）, post-operation EN with cholic acid 5 day group（n=6）. Liver function, inflammatory responses, hpid peroxidation, expression of ALB mRNA in the hver tissue, expression of liver Ki67 protein were detected. Results Compared with the EN without chohc acid 5 day group, serum AST, ALT and ALP were lower （P〈0.05）, serum ALB and IGF-1 were higher（P〈0.05）, serum IFN-γ, TNF-α and MDA content were lower （P〈O.05）, serum SOD was higher（P〈O.05）, expression of ALB mRNA in the liver tissue was higher（P〈0.05）, ex- pression of liver Ki67 protein was higher（P〈O.05） in the EN with cholic acid 5 day group. Conclusion Posthep- atectomy enteral nutrition with cholic acid in cirrhotic rats can speed up liver function recovery, reduce inflammatory responses and lipid peroxidation damage, promote liver protein synthesis and hver regeneration.

关 键 词：肝硬化 肝切除术 肠道营养 胆酸 

分 类 号：R657.3[医药卫生—外科学]