精氨酸对全胃肠外营养肝硬化大鼠肝脏的保护作用

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>0.05）,AST明显降低（P<0.01）,肝TG含量明显降低（P<0.01）,肝CHO含量明显降低（P<0.05）,门静脉血胰岛素、C-肽、胰高血糖素浓度明显升高（P<0.01）。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。

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

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.