不同营养途径对肝硬化大鼠肝切除术后肝脏功能的影响  

Effect of different nutritional support routes on liver function after hepatectomy in cirrhotic rats

作　　者：罗时敏[1] 曹杰[2] 罗建威[1] 谭明华[2] 

机构地区：[1]广州市第一人民医院综合外科,510180 [2]广州市第一人民医院普通外科,510180

出　　处：《中华临床营养杂志》2009年第3期161-165,共5页Chinese Journal of Clinical Nutrition

基　　金：基金项目：广州市医药卫生科技资助项目（2007-YB-011）和广州市科技攻关计划资助项目（2005Z3-E0181）

摘　　要：目的探讨不同营养途径对肝硬化大鼠肝切除术后肝脏功能的影响。方法6只正常大鼠作为正常对照组，30只肝硬化大鼠随机分为术前组6只，肝切除＋颈内静脉插管术后1d组6只，肝切除＋颈内静脉插管术后行肠外营养（PN）5d组6只，肝切除＋胃造瘘术后1d组6只，肝切除＋胃造瘘术后行肠内营养（EN）5d组6只。测定大鼠肝功能、肝组织白蛋白（ALB）mRNA的表达和肝组织信号传导和转录激活因子-3（STAT-3）、细胞增殖核抗原Ki67的蛋白表达。结果与PN5d组比较，EN5d组血清谷草转氨酶、谷丙转氨酶、碱性磷酸酶显著下降（P〈0．05），血清ALB、胰岛素样生长因子-1显著升高（P〈0．05），肝组织ALBmRNA表达显著升高（P〈0．05），肝组织STAT-3、Ki67蛋白表达显著升高（P〈0．05）。结论EN可以加快肝硬化大鼠肝切除术后肝功能的恢复，避免胆汁淤积，促进肝脏蛋白合成和残肝再生。Objective To explore the effects of different nutritional support routes on liver function after hepatectomy in cirrhotic rats. Methods Six normal rats severed as normal group, and 30 rats with liver cirrhosis were randomly divided into pre-operation group （ n = 6 ）, post-hepatectomy with jugular vein catheter 1 day group （ n = 6 ）, post-operation parenteral nutrition （PN） 5 days group （ n = 6 ）, post-hepatectomy with gastrostomy 1 day group （ n = 6 ）, and post-operation enteral nutrition （EN） 5 days group （ n = 6）. Liver functions, expression of al- bumin （ALB） mRNA in the liver tissue, expression of liver signal transducers and activators of transcription-3 （ STAT-3 ） and antigen Ki67 （ Ki67 ） protein were detected. Rzsttlt Compared ~ith Lhe PN 5 days group, seram aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase levels were significantly lower （P 〈 0. 05 ）, serum ALB and insulin-like growth factor-1 were significantly higher （ P 〈 0.05 ）, expression of ALB mR- NA in the liver tissue was significantly higher （ P 〈 0.05 ）, and expressions of liver STAT-3 and Ki67 protein were significantly higher （P 〈 O. 05 ） in the EN 5 days group. Conclusion Post-hepateetomy EN in cirrhotic rats can speed up liver function recovery, prevent cholestasis, and promote liver protein synthesis and liver regeneration.

关 键 词：肝硬化 肝切除术 肠外营养 肠内营养 

分 类 号：R657[医药卫生—外科学]