Study Of Salvia Miltiorrhiza On Newborn Total Parenteral Nutrition Associated Cholestasis

Objective The aim of this study was to establish a newborn rabbit model for total parenteral nutrition associated cholestasis(TPNAC),to study the possible pathogenesis of TPNAC and to evaluate the effectiveness of salvia miltiorrhiza in the management of TPNAC without discontinuing TPN.Methods 24 Newborn New Zealand White rabbits were divided into three groups.Group A (n=8),normal controls,group B(n=8),TPN only,group C(n=8),TPN plus salvia miltiorrhiza administration,2g/Kg/d.Laparotomy was then carried out under aseptic conditions at the eighth day. Portal blood and part of liver were obtained in all cases.Total bile acid(TBA),alanine aminotransferase (ALT),aspartate transaminase(AST),total protein,albumin,total bilirubin(TBil),conjugative bilirubin (DBil),and endotoxin(ET) were assayed and the structural change in liver were observed under light microscopes.Results TBA,ALT,total protein,albumin,TBil,DBil and ET concentrations of group B have extremely significant different from the group A(t'=5.04,t'=7.16,t=20.10,t=15.55,t'=10.16,t=24.29,P＜0.01),the different of AST concentration between the two groups is significant(t=2.33,P＜0.05).There are extremely significant different in TBA,ALT,total protein,albumin,TBil,DBil and ET concentrations between group C and group A(t=5.91,t'=6.10,t'=8.69,t=7.76,t'=7.02,t=12.53,t=6.79,P＜0.01).Between group C and group B,the different of TBA concentration is significant(t'=3.49,P＜0.05),while the different of ALT,AST,total protein,albumin,TBil,DBil and ET concentrations are extremely significant (t'=5.32,t'=4.06,t=8.32,t=10.19,t=4.01,t=12.14,t=9.97,P＜0.01).Under the light microscopes,it is edematous and physaliform degenerate bepatocytes,mild ectatic and congested central vein,ectatic venule and interlobular bile ducts and sporadic cholangiole cholestasis that can be seen in rabbit liver tissue of group B,while cholangiole cholestasis do not exist in rabbit liver tissue of group C.Conelusion The newborn rabbit modal for TPNAC has the same alterations in the hepatobiliary system as observed in humans,and it is fit for the studying of newborn TPNAC.Endotoxemia is an important pathogenesis of TPNAC.Salvia miltiorrhiza can alleviate endotoxemia and liver lesion without discontinuing TPN,and avoid the appearance of TPNAC.