摘要
目的探讨肝硬化大鼠肝部分切除术后肠外营养时氨基酸溶液的选择及评估。方法6只正常大鼠作为正常对照组熏24只肝硬化大鼠随机分为肝硬化术前组、肝硬化肝部分切除术后1天组、肝部分切除术后行复方18种氨基酸溶液的肠外营养5天组、肝部分切除术后行富含支链氨基酸穴BCAA雪的氨基酸溶液的肠外营养5天组,每组6只。检测大鼠肝功能、血糖及血清生长激素穴GH雪、胰岛素样生长因子-1穴IGF-1雪、胰岛素样生长因子结合蛋白-3穴IGFBP-3雪,肝组织行Ki67免疫组化染色,结果判断计数采用Ki67指数。结果与复方18种氨基酸溶液的肠外营养比较,富含BCAA的氨基酸溶液的肠外营养5天后血清谷丙转氨酶穴ALT雪、碱性磷酸酶穴ALP雪水平降低熏GH水平也降低熏而IGF-1、IGFBP-3水平升高穴P<0.05雪熏但肝Ki67指数无显著性差异穴P>0.05雪。血清GH水平与谷草转氨酶穴AST雪、ALT、ALP呈正相关熏与白蛋白穴ALB雪呈负相关穴P<0.05雪熏而血清IGF-1、IGFBP-3水平与AST、ALT、ALP呈负相关熏与ALB呈正相关穴P<0.05雪。结论肝硬化肝部分切除术后肠外营养应选择富含BCAA的氨基酸溶液,检测血清GH、IGF-1、IGFBP-3有助于对营养素选择的评估。
Objective To explore the selection and evaluation of amino acid solutions during parenteral nutri - tion after partial hepatectomy in the rats with liver cirrhosis.Methods Six normal rats severed as the normal group,24rats with liver cirrhosis were randomly divided into the pre - operation group( n= 6),the post - operation1day group( n= 6),post - operation compound18amino acid solution parenteral nutrition(PN)5day group( n= 6)and post - operation branched - chain amino acid(BCAA) - enriched amino acid solution PN5day group( n= 6).Liver function,blood glucose and serum growth hormone(GH),insulin like growth factor - 1(IGF - 1),insulin like growth factor binding protein - 3(IGFBP - 3)were measured.Liver Ki67immunohistochemistry staining was studied.Liver regeneration was evaluated through Ki67labeling index(Ki67LI).Results Compared with compound18amino acid solution PN group,serum alanine aminotransferase(ALT),alkaline phosphatase(ALP)and GH level were lower,serum IGF - 1and IGFBP - 3level were higher( P< 0.05),but liver Ki67LI was not different( P> 0.05)in the BCAA - enriched amino acid solutions PN group.Serum GH level were positively correlated with the serum aspartate aminotrans - ferase(AST),ALT,ALP and negatively correlated with serum albumin(ALB)( P< 0.05).Serum IGF-1and IGFBP-3level were negatively correlated with the serum AST,ALT,ALP and positively correlated with serum ALB( P< 0.05).Conclusion It is adequate to choose BCAA-enriched amino acid solution parenteral nutrition after partial hepatectomy with liver cirrhosis.Serum GH,IGF-1,IGFBP-3level may be helpful to evaluate nutrients.
出处
《中国临床营养杂志》
2004年第2期97-101,共5页
Chinese Journal of Clinical Nutrition
