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《International Journal of Laboratory Medicine》 2008-06
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Comparison of liver functional parameters of protection effect of early enteral nutrition on liver from the "second insult" injury

WANG Qian1,TIAN Wei-jun2,LIU Yun-de3,et al.1.Centre for Laboratory Medicine;2.General Surgery Institute,General Hospital,Tianjin Medical University,Tianjin,300052,China;3.Department of Laboratory Medicine,Tianjin Medical University,Tianjin,300052,China  
Objective The effect of the early enteral nutrition on liver protection from the "second insult" injury caused by the critical diseases was detected by hepatic serology indicators.The aim of the study is to sift the sensitive indicators.Methods The rat models of "second insult" caused by hemorrhagic shocklipopolysaccharide intraperitoneal injection and enteral or parenteral nutrition were established.According to the nutrition types,the rats were divided into three groups including enteral nutrition group(group EN),parenteral nutrition group(group PN)and compounded nutrition group(group EPN).Nutrition was infused 12 h after operation and supplied for 5 consecutive days for each of group.Blood was taken on day 1,3 and 5 for hepatic serology indicators determination.The rats were sacrificed on day 5 and the liver tissue was obtained.The expression of liver TLR4 protein was detected via immunohistochemistry assay.Results As compared with those of the 1st post-operation,retinol binding protein(RBP)increased day by day in all three groups;transferring(TRF)and prealbumin(PA)were elevated while adenine nucleotide deaminase(ADA)declined significantly in group EN and group EPN;glutamyl transpeptidase(γ-GT)and alkaline phosphatase(ALP)increased in group PN.Compared with those of group PN 5 days after operation,RBP increased,while ALT,AST,ADA,γ-GT,and ALP decreased markedly.TLR4 was high expressed in group PN comparing with that of group EN and group EPN.Conclusion The early enteral nutritional support protects the liver from the "second insult" injury,beneficial to liver functional restoration.RBP and ADA is the sensitive indicators reflecting the nutritional status and hepatocellular damage respectively.TLR4 contributes to judging the early injury degree of endotoxia to liver.
【Fund】: 天津市卫生局科技基金资助项目(No.05KYZ68)
【CateGory Index】: R459.3
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