精氨酸对全胃肠外营养肝硬化大鼠肝脏的保护作用  

The protective effect of arginine on the liver in the cirrhotic rats with TPN

作　　者：罗时敏[1] 梁力建[2] 

机构地区：[1]江西省人民医院普外科,南昌330006 [2]中山医科大学附属第一医院肝胆外科,广州510080

出　　处：《肝胆胰外科杂志》2001年第1期26-28,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的 :观察精氨酸对肝硬化大鼠全胃肠外营养时的肝保护作用。方法 :13只肝硬化大鼠随机分成 2组 ,A(TPN)组 7只 ,B(TPN +精氨酸 )组 6只。观察大鼠生存情况 ,大鼠实验前后体重、肝重 /体重比值的变化 ,大鼠氮平衡情况 ,肝功能、肝甘油三酯 (TG)、胆固醇 (CHO)含量、门静脉血胰岛素、C 肽、胰高血糖素浓度的变化及肝脏病理组织学改变情况。结果 :除TPN组一只大鼠因输液过快 ,肺水肿死亡外 ,其余大鼠均成活 ,实验前后体重无明显变化。与A组比较 ,B组血清TBIL、ALT、ALB、A/G比值差异无统计学性 (P >0 .0 5 ) ,AST明显降低 (P <0 .0 1) ,肝TG含量明显降低 (P <0 .0 1) ,肝CHO含量明显降低 (P <0 .0 5 ) ,门静脉血胰岛素、C 肽、胰高血糖素浓度明显升高 (P <0 .0 1)。肝脂肪变性程度 ,A组为Ⅳ级 ,B组Ⅱ级。电镜观察 ,A组肝细胞质内有多量的脂肪滴 ,但B组减少 ,两组肝细胞质内线粒体均轻度肿胀。结论 :精氨酸可以预防和治疗硬化肝TPN时进一步的肝损害 ,同时也需白蛋白强化。Objective:To observe the protective function of arginine to liver in the cirrhotic rats administrated by TPN.Methods:Thirteen cirrhotic rats are divided into two groups randomly: TPN group(n=7) and TPN+arginine group(n=6). The survival rate, body weight, live body weight ratio, nitrogen balance, liver function, hepatic triglycerin(TG) and cholesterol(CHO), the level of portal insulin, C peptide and glucagon were measured and histologic changes of the liver were observed.Results:All animals survived but one rat died of pneumonedema in TPN group. Body weight did not change significantly. Compared with TPN group, serum TBIL, ALT, ALB and A/G ratio had no significant changes(P>0.05). AST,liver TG decreased significantly(P<0.01), liver CHO and the levels of portal insulin, C peptide and glucagon increased significantly(P<0.01). As far as degree of fatty degeneration in the liver is concerned, TPN group was class Ⅳ, while TPN+arginine group was Class Ⅱ. Electron microscopy revealed that hepatocytes had a lot of lipid droplets on the TPN group but less on the TPN+arginine group, while mitochondria of both groups had slight swelling.Conclusion:Arginine can prevent the further injury when adminsted TPN on cirrhotic liver. ALB infusion is also advised.

关 键 词：胃肠外营养全 肝硬化 精氨酸 动物实验替代试验 

分 类 号：R657.3[医药卫生—外科学]