A POSSIBLE BENEFICIAL EFFECT OF METRONIDAZOLE IN REDUCING TPN-ASSOCIATED LIVER-FUNCTION DERANGEMENTS
A POSSIBLE BENEFICIAL EFFECT OF METRONIDAZOLE IN REDUCING TPN-ASSOCIATED LIVER-FUNCTION DERANGEMENTS
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DOI：
10.1016/0022-4804(85)90049-6
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发表时间：
1985-01-01
影响因子：
2.2
通讯作者：
BJORNSON, HS
中科院分区：
文献类型：
--
作者：
FREUND, HR;MUGGIASULLAM, M;BJORNSON, HS
胆汁淤积和肝脏脂肪浸润是全肠外营养（TPN）的常见并发症。根据最近提出的TPN相关肝功能紊乱可能与肠道厌氧菌过度生长有关的建议，研究了甲硝唑对大鼠TPN期间肝功能紊乱的影响。在氨基酸和葡萄糖或氨基酸和葡萄糖和脂肪的TPN 5天后，所有组均表现出轻度体重增加、正氮平衡、肝脏重量增加、肝脏：体重比增加、肝酶水平增加和肝脏脂质含量增加。以15 mg/kg/天剂量给予甲硝唑可显著降低肝脏脂质含量，从对照组的0.077 g脂肪/g肝脏降至0.053 g脂肪/g肝脏。在营养有效和充足的TPN期间，甲硝唑在减少大鼠肝脏脂肪蓄积方面的疗效表明，肠道厌氧菌植物群可能参与TPN相关肝功能紊乱的发病机制，至少部分参与。然而，这些变化的各种生化和形态学表达以及肝脏重量、肝脏：体重比、肝酶和肝脂肪含量改善之间的差异表明TPN相关肝损伤的多因素机制。
Cholestasis and fatty infiltration of the liver are common complications of total parenteral nutrition (TPN). Following a recent suggestion that TPN-associated liver function derangements may be related to intestinal overgrowth of anaerobic bacteria, the effect of metronidazole on hepatic dysfunction during TPN in rats was investigated. After 5 days of TPN with either amino acids and glucose or amino acids with glucose and fat, all groups exhibited a mild weight gain, positive nitrogen balance, increased liver weight, increased liver: body weight ratio, increased levels of liver enzymes, and increased hepatic lipid content. The administration of metronidazole at 15 mg/kg/day significantly decreased the hepatic lipid content from 0.077 g fat/g liver for controls to 0.053 g fat/g liver. The efficacy of metronidazole in reducing hepatic fat accumulation during nutritionally effective and adequate TPN in rats suggests the possible involvement of anaerobic bacterial flora of the intestinal tract, at least in part, in the pathogenesis of TPN-associated liver function derangements. However, the various biochemical and morphological expressions of these changes and the discrepancy between unchanged liver weight, liver: body weight ratio, liver enzymes, and the improved hepatic fat content suggest multifactorial mechanisms for TPN-related liver damage.