肝硬化大鼠肝切除术后不同营养支持途径的对比研究

目的 探讨肝硬化大鼠肝切除术后不同营养支持途径的作用.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PN 5 d组6只,肝切除+胃造瘘术后1 d组6只,肝切除+胃造瘘术后行EN 5 d组6只.测大鼠肝功能、免疫功能、炎症反应和脂质过氧化指标.结果 与PN 5 d组比较,EN 5 d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),外周血CD3+、CD4+、CD4+/CD8+显著升高(P＜0.05),血清IL-6、IFN-γ、TNF-α、MDA显著下降(P＜0.05),血清SOD活性显著升高(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,改善术后免疫功能低下,减轻炎症反应和脂质过氧化损伤.

Comparative study on posthepatectomy different nutritional support routes in cirrhotic rats

Objective To explore the role of posthepatectomy different support routes in cir-rhotic rats. Methods A total of 6 normal rats severed as normal group, 30 rats with liver cirrhosis were randomly divided into pre-operation group (n＝6), posthepatectomy with jugular vein catheter 1 day group (n＝6), post-operation PN 5 day group (n＝6), posthepatectomy with gastrostomy 1 day group (n＝6), post-operation EN 5 day group (n＝6). Liver function, immunological function, in-flammatory responses, and lipid peroxidation were determined. Results Compared with the PN 5 day group, serum AST, ALT and ALP were lower(P＜0.05), serum ALB and IGF-1 were higher(P＜0.05), the peripheral blood CD3+ , CD4+ and CD4+/CD8+ ratio were higher(Pz＜0.05), serum IL-6,IFN-γ, TNF-α and MDA content were lower(P＜0.05), serum SOD activity was higher(P＜0.05) in the EN 5 day group. Conclusion Posthepatectomy enteral nutrition in cirrhotic rats can speed up liver function recovery, prevent cholestasis, promote liver protein synthesis, ameliorate the damage of im-munological function and reduce inflammatory responses and lipid peroxidation damage.