The effects of ketone body infusion on liver regeneration

本文观察了葡萄糖为主的TPN和单乙酰乙酸葡萄糖TPN对大鼠70%肝切除后代谢变化和肝再生的影响。在氯胺酮麻醉下，对雄性Wistar大鼠进行70%肝切除术。根据TPN饮食分为3组：5%葡萄糖组、20%葡萄糖组和5%葡萄糖-15%单乙酰乙酸组。通过残肝重/体重比、有丝分裂指数和BrdU阳性细胞标记指数分析肝再生情况。采用体重变化和血浆GPT、胆红素、总蛋白、尿素氮和肌酐进行一般评估。术后6 h测定肝脏能荷，5%葡萄糖组和单乙酰乙酸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/体重比低于20%葡萄糖组和单乙酰乙酸葡萄糖组。术后6小时，三组大鼠肝脏能量负荷无显著差异，提示高糖负荷可能抑制肝脏再生。结果还显示，5%葡萄糖输注组不能维持体重，肝脏增重较低。单乙酰乙酸-葡萄糖混合物在术后至少6小时对肝脏能量负荷没有不良影响。在大面积肝切除术后，单乙酰乙酸-葡萄糖混合物给药对肝再生和体重增加的效果优于葡萄糖为主的肠外营养。

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.