The effects of ketone body infusion on liver regeneration

研究了葡萄糖基TPN和单乙酰乙酰-葡萄糖TPN对大鼠70%肝切除术后肝脏代谢变化和肝脏再生的影响。在氯胺酮麻醉下，雄性Wistar大鼠肝切除70%。按TPN日粮分为5%葡萄糖组、20%葡萄糖组和5%葡萄糖-15%单乙酰乙酰素组。采用残肝重体比、有丝分裂指数和BrdU阳性细胞标记指数分析肝再生情况。用体重变化和血浆GPT、胆红素、总蛋白、尿素氮、肌酐作一般评价。术后6小时测量肝脏能量电荷。5%葡萄糖组和单乙酰丙酮-葡萄糖组的标记指数和有丝分裂指数均高于20%葡萄糖组。5%葡萄糖组的体重变化和残肝重与体重比低于20%葡萄糖组和单乙酰乙酰葡萄糖组。术后6小时，三组肝脏能量充电无显著差异。本实验结果表明，高糖负荷有抑制肝脏再生的可能。结果还显示5%葡萄糖输注组小鼠体重维持失败，肝脏增重低。单乙酰乙酯-葡萄糖混合物在术后至少6小时内对肝脏能量充电无不良影响。大面积肝切除术后，单乙酰乙酯-葡萄糖混合给药对肝脏再生和体重增加的影响优于葡萄糖基础的肠外营养。

The effects of glucose based TPN and monoacetoacetin-glucose TPN on metabolic changes and liver regeneration after 70% hepatectomy was investigated in rats. Under ketamine anesthesia male Wistar rats were subjected to 70% hepatectomy. They were divided into three groups according to their TPN diet : 5% glucose group, 20% glucose group and 5% glucose-15% monoacetoacetin group. Liver regeneration was analyzed by remnant liver weight to body weight ratio, mitotic index and labeling index for BrdU positive cells. Body weight change and plasma GPT, bilirubin, total protein, urea nitrogen and creatinine were utilized for general assessment. Liver energy charge was measured six hours after surgery.The labeling indices and the mitotic indices of 5% glucose group and monoacetoacetin-glucose group were higher than those of 20% glucose group. The body weight change and remnant liver weight to body weight ratio of 5% glucose group were lower than those of 20% glucose group and monoacetoacetin-glucose group. There was no significant difference in liver energy charge among these three groups at six hours after surgery.The results of this experiment show a possibility of suppression of liver regeneration by high glucose load. The results also show the failure of maintaining body weight and the low liver weight gain with 5% glucose infusion group. Monoacetoacetin-glucose mixture has no adverse effect on liver energy charge at least six hours after surgery. After massive liver resection, monoacetoacetin-glucose mixture administration presents better effects on liver regeneration and body weight gain than glucose based parenteral nutrition.