不同脂肪乳剂对阻塞性黄疸大鼠肝脏功能和形态学的影响

目的：比较不同脂肪酸来源的全胃肠外营养（TPN）对胆总管结扎大鼠肝脏功能和形态学的影响。观察不同脂肪酸对阻塞性黄疸大鼠受损肝脏的作用，为临床阻塞性黄疸患应用TPN提供实验依据。方法：采用SD大鼠36只，随机分4组，每组9只，其中A组为假手术＋经口饮食对照组；余3组均行胆总管结扎术：B组为经口饮食对照组，C，D组分别给予以长链（LCT）或中长链脂肪酸（MCT／LCT）为脂肪来源的TPN。结果：应用长链脂肪酸大鼠的血清AKP，g-GT，血清总胆红素，直接胆红素和胆汁酸水平均高于应用中长链脂肪酸大鼠。对实验大鼠肝脏形态学观察发现，应用LCT的大鼠肝细胞损害较经口饮食对照大鼠有所加重，而应用MCT／LCT的大鼠肝细胞损害未见加重。结论：短期应用合理糖脂比，热氮比和合适脂肪来源的TPN并不加重阻塞性黄疸大鼠的肝脏损害和胆红素代谢紊乱。

Influences of different fat emulsions on liver function and morphology of obstructive jaundice rats

Objective This study investigated the effects of different fat emulsions on impaired livers of obstructive jaundice rats to provide laboratory evidence for applying TPN to clinic obstructive jaundice patients by comparison of influences of TPN of different fat sources on liver function and morphology of common bile duct ligated rats. Methods 36 SD rats were adopted in the experiment,divided into 4 groups randomly (n=9).Group A was Sham oral diet.Common bile duct ligation was performed on another 3 groups;oral diet was assigned to group B,and TPN with LCT or MCT/LCT were assigned to groups C and D respectively. Results Serum AKP,g-GT,serum total bilirubin,direct bilirubin and bile acid levels of the rats receiving LCT were higher than those of the rats receiving MCT/LCT.The morphologic observations of rats'livers showed that the liver impairment of rats receiving LCT was aggravated,while it was not seen in the rats receiving MCT/LCT. Conclusions Short-term TPN with reasonable glucose/lipid ratio and calorie/nitrogen ratio and suitable source of fat would not aggravate liver impairment and bilirubin metabolic turbulence.