| Objective:To establish the total parenteral nutrition(TPN)rat model and study the effects of soybean oil lipid emulsions(SOLE)and olive oil lipid emulsions(OOLE)on liver function of TPN rats,provide the theoretical support for clinical parenteral nutrition treatment.Methods:36 SD male rats were given unilateral external jugular vein catheterization.After 48 hours,the rats were randomly divided into three groups which was the control group(Control group),the soybean oil lipid emulsion group(SOLE group)and the olive oil lipid emulsion group(OOLE group)respectively.The control group were pumped fat-free TPN preparations,the SOLE group and the OOLE group were pumped with which containing soybean oil lipid emulsion and olive oil lipid emulsion TPN preparations.On the 3rd day and the 7th day,the liver function and biochemical examination were tested,then put to death in the rat and collect the liver tissue specimens,by enzyme linked immunosorbent assay(ELISA)to detect the tumor necrosis factor-?(TNF?)and interleukin 6(IL-6).Immune indexes were detected by flow cytometry.Meanwhile,the content of malondialdehyde(MDA)was detected by thiobarbituric acid reactive substance(TBARS)colorimetrically,and the activity of superoxide dismutase(SOD)was detected by N-Blue tetrazole photochemical reduction method.After all,the liver pathological morphology were observed under HE staining as well as the score for pathology was underwent by the Loff methods.In addition,58 patients with gastrointestinal tumors surgery who were treated with Fat emulsion,Amino acids(17)and Glucose(11%)for at least 7 days of parenteral nutrition support were selected from January 2020 to August 2020 in the Second Hospital of Lanzhou University as the research object.The changes of liver function before and after treatment were observed and compared.Results:(1)In terms of liver function indexes,there was no statistical difference in the liver function indexes of the rats in each group before administration(P>0.05).The levels of TG,TBIL,ALT,ALP between the SOLE group and the OOLE group gradually increased with time,which were higher than those of the Control group,but the ALB level of former gradually decreased with time(P<0.05).On the 3rd day,the TG level of the SOLE group was higher than that of the OOLE group(P<0.05),and there was no statistical difference in the other indexes of the 2 groups(P>0.05).On the 7th day,the levels of TG,TBIL,ALT in the OOLE group were significantly lower than those in the SOLE group(8.38±2.44vs24.71±4.66,20.18±2.23vs26.20±3.12,28.92±3.67vs31.83±2.58,P<0.05),but there was no statistical difference in the TBA,γ-GT,ALP of the 2 groups(P>0.05).Clinical studies have shown that in addition to TG,γ-GT,TBIL and TBA,the ALT,ALP levels of parenteral nutrition at day 3 and day 7 were significantly higher than those before treatment,but the levels of their ALB were significantly lower than that before treatment(P<0.05);the ALB,ALT,ALP levels of parenteral nutrition at day 7 were significantly higher than those of parenteral nutrition at day 3(P<0.05).(2)In terms of inflammation indexes,there was no statistical difference in the inflammation indexes of the rats in each group before administration(P>0.05).On the 3rd day,the levels of TNF?,IL-6 between the SOLE group and the OOLE group were significantly increased,which were higher than those in the Control group,but the TNF?level of the latter was significantly lower than that of the former(P<0.05).On the 7th day,the TNF?level of the OOLE group decreased significantly,but it was still higher than that of before administration and the Control group(35.38±2.58vs27.48±2.63,35.38±2.58vs27.50±2.67,P<0.05).On the 3rd and 7th day,there was no statistical difference in the level of IL-6 between the SOLE group and the OOLE group(P>0.05).(3)In terms of the immune indexes,there was no statistical difference in the immune indexes of the rats in each group before administration(P>0.05).On the 3rd day,the levels of CD4~+,CD8~+,CD3~+,Ig G,C3,C4 between the SOLE group and the OOLE group decreased significantly,which were lower than those in the Control group(P<0.05),but there was no statistical difference between the 2 groups(P>0.05).On the 7th day,the levels of CD4~+,CD4~+/CD8~+,CD3~+,Ig G,C3,C4 in the SOLE group were significantly lower than those in the OOLE group,but the CD4~+,CD3~+,Ig G,C3,C4 levels of the latter were still lower than those of before administration and the Control group(P<0.05).(4)In terms of lipid oxidation indexes,On the 7th day,the SOD activity of the OOLE group was significantly higher than that of the Control group and the SOLE group(P<0.05),but there was no significantly difference in SOD activity between the Control group and the SOLE group(257.84±25.04vs260.28±25.29,P>0.05).The MDA level of the SOLE group and the OOLE group was significantly higher than that of the Control group(P<0.05),but the MDA level of the SOLE group was significantly higher than that of the OOLE group(3.11±0.77vs 5.19±1.22,P<0.05).(5)In terms of pathological examination of liver,the HE scores in the SOLE group and OOLE group were both significantly higher than the Control group(P<0.05),but the HE scores in the OOLE group was lower than the SOLE group(1.33±0.98vs2.17±0.94,P<0.05).Conclusions:(1)Use of TPN containing fat preparations would affect liver function,and cause an increase in TNF?and IL-6 inflammatory cytokines,an decrease in immunity function as well as a decrease in SOD and an increase in MDA,the antioxidant index of lipids.(2)The effect of olive oil lipid emulsions on TNF?,CD4~+,CD4~+/CD8~+,CD3~+,Ig G,C3,C4,SOD,MDA and liver pathology score in TPN rats was less than that of soybean oil lipid emulsions,so as to reduce inflammation,improve cell immune function,reduce lipid peroxidation and reduce the effect of TPN containing fat preparation on liver function. |
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