The use of beta-adrenergic blockade in preventing trauma-induced hepatomegaly
The use of beta-adrenergic blockade in preventing trauma-induced hepatomegaly
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DOI：
10.1097/01.sla.0000193834.07413.91
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发表时间：
2006-01-01
影响因子：
9
通讯作者：
Herndon, DN
中科院分区：
文献类型：
--
作者：
Barrow, RE;Wolfe, RR;Herndon, DN
目的：本研究的目的是检验烧伤儿童的肝肿大可以通过阻断脂肪分解和减少输送到肝脏的游离脂肪酸来减轻或逆转的假设。背景数据摘要：严重烧伤儿童的加速脂肪分解已被证明在肝脏甘油三酯的积累中发挥着重要作用。受伤后存活 10 天或更长时间的严重烧伤儿童通常肝脏肿大，通常是其性别、年龄和体重正常大小的两倍或更多。 方法：对 98 名接受普萘洛尔（β-肾上腺素能阻滞剂）或安慰剂治疗的儿童进行了研究，这些儿童年龄在 2 至 18 岁，烧伤面积超过身体表面的 40%。通过超声波扫描测量肝脏重量。通过双图像 X 射线吸收测定法识别身体成分变化，并通过全身钾 40 闪烁计数进行验证。在普萘洛尔或安慰剂治疗前后收集废弃的腹部皮肤脂肪组织进行微阵列分析。结果：在未接受普萘洛尔治疗的严重烧伤儿童中，80% 的肝脏大小增加了 100% 或更多，而接受普萘洛尔治疗的烧伤儿童中，86% 在受伤后的同一时间段内表现出肝脏大小减少或没有变化。普萘洛尔治疗后脂肪组织的基因表达模式表明，所有已识别的与脂质代谢相关的基因均下调。结论：此处报告的数据支持这样的假设：β-肾上腺素能阻断可以通过抑制脂肪分解和减少肝血流量来减少脂肪酸向肝脏的输送和严重烧伤儿童中常见的肝充血。
Objective: The objective of this study was to test the hypothesis that hepatomegaly in burned children can be attenuated or reversed by blocking lipolysis and reducing free fatty acids delivered to the liver.Summary Background Data: Accelerated lipolysis in severely burned children has been shown to play an important role in the accumulation of hepatic TGs. Severely burned children who survive 10 days or more after injury commonly have enlarged livers often twice or more normal size for their sex, age, and weight.Methods: Ninety-eight children, 2 to 18 years of age, with burns covering more than 40% of their body surface and who received either propranolol (beta-adrenergic blockade) or placebo were studied. Liver weights were measured by ultrasonic scanning. Body composition changes were identified by dual-image x-ray absorptiometry and validated by whole-body potassium-40 scintillation counting. Discarded abdominal cutaneous adipose tissue was collected before and after propranolol or placebo for microarray analysis.Results: In 80% of severely burned children studied not receiving propranolol, liver sizes increased by 100% or more while 86% of burned children receiving propranolol showed a decrease or no change in liver size over the same period of time after injury. Gene expression patterns of adipose tissue after propranolol treatment showed that all of the identified genes related to lipid metabolism were down-regulated.Conclusions: Data reported here support the hypothesis that beta-adrenergic blockade can reduce delivery of fatty acids to the liver and hepatic congestion commonly found in severely burned children by inhibiting lipolysis and reducing hepatic blood flow.