Eizaguirre I, Aldámiz L, Aldazábal P, García Urkia N, Asensio A B, Bachiller P, García Arenzana J M, Ruiz J L, Sanjurjo P, Perez Nanclares G
Pediatr Surg Int. 2001 May;17(4):280-3. doi: 10.1007/s003830100594.
Alterations in the antioxidative system have been observed during total parenteral nutrition (TPN). Light exposure or changes in the composition of TPN formulas may affect this system. Bacterial translocation (BT) is frequent under TPN and may be related to oxidative status. The aim of this study was to determine the adverse effects of standard and glutamine-enriched TPN, with or without light exposure, on oxidative status (liver and kidney-reduced glutathione, GSH) and its relationship to BT. Thirty-three adult Wistar rats underwent central-venous cannulation and were randomly assigned to one of four groups receiving different TPN regimes for 10 days. The TPN group (n = 10) had standard TPN, the TPN(-) group (n = 8) standard TPN without light exposure, the GTPN group (n = 8) glutamine-enriched TPN, and the GTPN(-) group (n = 7) glutamine-enriched TPN without light exposure. A sham group (n = 16) receiving chow and water ad libitum and saline i.v. served as controls. At the end of the experiment, GSH was determined in liver and kidney tissue. Mesenteric lymph nodes and peripheral and portal blood samples were cultured for BT. Compared to sham rats, TPN groups had statistically significant lower GSH levels, but there were no differences between standard or glutamine-enriched groups or light-exposure groups. Sham animals had 12% BT. Significantly higher BT (P < 0.05) occurred in TPN rats: 70% in the TPN group, 88% in the TPN(-) group, 86% in GTPN (-) animals, and only 50% in the GTPN group (P = 0.06 vs TPN group). In conclusion, (1) TPN reduces antioxidant capacity; (2) glutamine supplementation or light protection does not improve tissue antioxidant capacity under TPN; (3) the absence of light exposure does not improve TPN-related BT; and (4) glutamine supplementation tends to reduce BT only in the presence of light.
在全胃肠外营养(TPN)期间,已观察到抗氧化系统的改变。光照或TPN配方组成的变化可能会影响该系统。TPN时细菌易位(BT)很常见,且可能与氧化状态有关。本研究的目的是确定标准和富含谷氨酰胺的TPN在有或无光照情况下对氧化状态(肝脏和肾脏中还原型谷胱甘肽,GSH)的不良影响及其与BT的关系。33只成年Wistar大鼠进行中心静脉插管,并随机分为四组之一,接受不同的TPN方案10天。TPN组(n = 10)接受标准TPN,TPN(-)组(n = 8)接受无光照的标准TPN,GTPN组(n = 8)接受富含谷氨酰胺的TPN,GTPN(-)组(n = 7)接受无光照的富含谷氨酰胺的TPN。一个假手术组(n = 16)自由进食和饮水并静脉注射生理盐水作为对照。实验结束时,测定肝脏和肾脏组织中的GSH。对肠系膜淋巴结以及外周血和门静脉血样本进行BT培养。与假手术大鼠相比,TPN组的GSH水平在统计学上显著较低,但标准或富含谷氨酰胺的组之间或光照组之间没有差异。假手术动物的BT发生率为12%。TPN大鼠中BT发生率显著更高(P < 0.05):TPN组为70%,TPN(-)组为88%,GTPN(-)组动物为86%,而GTPN组仅为50%(与TPN组相比,P = 0.06)。总之,(1)TPN会降低抗氧化能力;(2)补充谷氨酰胺或光照防护并不能改善TPN时的组织抗氧化能力;(3)无光照并不能改善与TPN相关的BT;(4)仅在有光照的情况下,补充谷氨酰胺倾向于降低BT。