富含谷氨酰胺二肽的新型氨基酸对全肠外营养短肠综合征大鼠血清蛋白及肝功能的影响

Influence of parenteral nutrition with amino acid compound rich in glutamine on serum proteins and liver function of rats after small bowel resection

目的观察富含谷氨酰胺二肽的新型氨基酸对Ｗｉｓｔａｒ大鼠短肠模型血清蛋白和肝功能的影响及探讨其减轻脂肪乳剂引起肝损害的作用机制。方法３０只Ｗｉｓｔａｒ雄性大鼠随机分为富含谷氨酰胺二肽新型氨基酸组（２０ＡＡ组）、标准组（１７ＡＡ组）、无氮组，观察不同组动物之间血清总蛋白、白蛋白、前白蛋白（ｐｒｅ－ａｌｂｕｍｉｎ，ＰＡ）、纤维结合蛋白（ｆｉｂｒｏｎｅｃｔｉｎ，ＦＮ）以及丙氨酸转氨酶和胆红素的变化。结果２０ＡＡ组血清总蛋白、纤维结合蛋白与１７ＡＡ组相比无明显差别，但高于无氮组（Ｐ＜０．０５），白蛋白、前白蛋白明显高于１７ＡＡ组和无氮组（Ｐ＜０．０５）；总胆红素和直接胆红素３组之间均有差别，２０ＡＡ组最低（Ｐ＜０．０５）。结论富含谷氨酰胺二肽新型氨基酸能提高短肠综合征大鼠血清白蛋白、前白蛋白的含量，抑制全肠外营养（ＴＰＮ）引起的肝内淤胆作用，减轻脂肪乳剂对肝功能损害，增强其生存能力。

Objective To investigate the effects of amino acid compound rich in glutamine on liver function and serum proteins of rats after massive small bowel resection (SBR). Methods After central catheterizahon, 30 Wistar rats were given an 75% mid-gut resection, leaving 15cm of the proximal jejunum and 10cm of the distal ileum. Bowel continuity was restored by an end-to-end jejunoileal anastomosis of interrupted 5 - 0 silk suture. These 30 rats were divided into three groups: (1) 20 amino acids TPN group (20AA group, n = 10); (2) 17 amino acids TPN group (17AA group, n = 10); (3) free-nitrogen group (n = 10). The first group and the second group were isonitrogenous. The free-nitrogen group was not given amino acids and protein, glucose and intralipid were given by central vena cava. Three groups were isocaloric. The body weight, liver function, nitrogen balance, scrum predsdrin and fibronechn were measured. Results All indices above in 20AA group and 17AA group were better than that in free- nitrogen group (P<0.05). The 20AA group had better they weight, nitrogen balance than 17AA group. The serum prealbumin in 20AA group was increased compared with 17AA group(P<0.05). The direct reacting bilirubin and total bilirubin in 17AA group was increased compared with 20AA group (P < 0. 05), but the total protein and albumin were not different between 20AA and 17AA groups.Concusion 20AA TPN pop possesses a better nutritional support, which can prevent cholestasis associated with TPN and reduce liver dysfunction.