肝移植术后营养支持对移植肝功能影响
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国家自然基金资助项目(10571084)


Effects of nutrition surport on function of liver graft after liver transplantation
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    摘要:

    目的:探讨非全肠外营养(TPN)、传统TPN及添加丙氨酰谷氨酰胺(Ala-Gln)的TPN对肝移植后移植肝功能的影响。方法:将35例肝移植患者随机分3组:术后未经TPN(饮食组)、不添加Ala-Gln的TPN组(传统组),添加Ala-Gln的TPN组(二肽组)。TPN于术后第2天予以等热量(每千克体重104.6 kJ)、等氮量(每千克体重0.16 g)共7天。 监测术后第2、9天肝功能指标。结果: 移植后第9天,二肽组的胆碱酯酶(CHE)与饮食组和传统组比较有更显著的升高(P < 0.01);传统组、二肽组的载脂蛋白B(APOB)与饮食组比较有更显著的升高(P < 0.01);二肽组的天门冬氨酸氨基转移酶(AST)与饮食组和传统组比较有更显著的下降(P < 0.01、P < 0.05)。结论:肝移植术后进行TPN治疗,有利于移植肝合成功能的改善和缺血再灌注损伤的修复;而添加Ala-Gln的TPN治疗则更为有利。

    Abstract:

    Objective: To explore the effects of dipeptide-supplemented total prenteral nutrition(TPN), traditional TPN on the function change of liver graft after orthotopic liver transplantation. Methods:Thirty-five patients were randomly divided into three groups: diet group(receiving common diet), traditional group(receiving TPN without Ala-Gln), dipeptide group(receiving TPN and Ala-Gln). Patients in traditional group and dipeptide group received isocaloric[104.6 kJ/(kg·d)] and isonitrogenous[0.16 g/(kg·d)] on the second day to the eighth day after transplantation. Liver function-related index was measured on the second day and the ninth day after liver transplantation respectively. Results: Aspartate aminotransferase(AST) of dipeptide group decreased more significantly compared with diet and traditional group(P < 0.01,P < 0.05);Apolipoprotein B(APOB) of traditional group and dipeptide group increased more significantly compared with diet group(P < 0.01);Cholinesterase(CHE) of dipeptide group increased more significantly compared with diet and traditional group(P < 0.01)on the ninth day after OLT. Conclusion:TPN improves the function and recovery of ischemia reperfusion injury of graft. Ala-Gln increases the effects of TPN.

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王 伟,仇毓东,刘绪舜,王 峰,费 阳.肝移植术后营养支持对移植肝功能影响[J].南京医科大学学报(自然科学版),2006,(11):1051-1055

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  • 收稿日期:2006-05-09
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