Mashima Y
JPEN J Parenter Enteral Nutr. 1979 May-Jun;3(3):139-45. doi: 10.1177/014860717900300306.
To investigate the possible cause of hepatomegaly during TPN, chemical analyses were performed on the livers of puppies weighing around 2 kg, supported by TPN for 1 wk, under 3 different calorie levels: Group I (5) under 135 cal/kg as standard calorie, Group 2 (6) fed ad libitum with dog food, Group 3 (5) received TPN for 7 days at 135 cal/kg/day, Group 4 (5) TPN at 200 cal/kg/day, and Group 5 (5) at 270 cal/kg/day. The livers of puppies starved for 24 hrs and orally fed were studied as controls.
为研究全胃肠外营养(TPN)期间肝肿大的可能原因,对体重约2kg的幼犬肝脏进行了化学分析。这些幼犬在3种不同热量水平下接受TPN支持1周:第一组(5只)热量为135千卡/千克作为标准热量,第二组(6只)随意喂食狗粮,第三组(5只)以135千卡/千克/天的热量接受TPN 7天,第四组(5只)以200千卡/千克/天的热量接受TPN,第五组(5只)以270千卡/千克/天的热量接受TPN。将饥饿24小时后经口喂食的幼犬肝脏作为对照进行研究。
1)第二组和第三组持续出现显著肝肿大,伴有贫血性变色以及血清谷草转氨酶(sGOT)、谷丙转氨酶(sGPT)和碱性磷酸酶升高。2)饥饿组、喂食第一组、第二组和第三组的肝脏重量分别为66.0±7.5克、82.8±18.5克、108.32±21.36克和247.06±17.83克。3)肝脏中的糖原和水分含量分别为:饥饿组0.17±0.07克和48.75±5.75毫升,喂食组5.37±3.24克和60.72±13.71毫升,第一组10.35±4.87克和79.4±16.84毫升,第二组45.05±7.41克和173.31±21.26毫升,第三组45.19±20.47克和178.45±56.63毫升,这表明体重增加可由肝脏中糖原和水分沉积的增加来解释。4)第二组和第三组肝脏中的甘油三酯增加到对照组的2倍。这些结果提示,在临床TPN中,热量过载可能导致肝肿大,伴有糖原和水分蓄积以及血清酶升高。