全靜脈營養輸入不同脂肪乳劑對敗血症老鼠腹水中 cytokine 的分泌及因cytokine 分泌引致之代謝變化之影響

Abstract

本研究在探討全靜脈營養(total parenteral nutrition, TPN)溶液中，添加富含 n-3 脂肪酸之魚油乳劑或富含n-6 脂肪酸之紅花子油乳劑對敗血症老鼠細胞激素 分泌及營養素代謝之影響。實驗將Wistar 雄鼠分為兩組，由頸靜脈插管後，完 全由TPN 方式供給營養一星期，兩組輸入之TPN 溶液營養素含量均完全相同只 有脂肪乳劑不同，脂肪乳劑分別由魚油及紅花子油製成。七天後每一實驗組再細 分為兩小組，其中一組老鼠以盲腸穿刺法(cecal ligation and puncture)引致敗血 症，另一組則只做sham operation，本實驗共分成四組：魚油控制組（FOC, n=7）， 魚油敗血症組（FOS, n=8），紅花子油控制組(SOC, n=8)，紅花子油敗血症組(SOS, n=9)，各組在禁食24 小時後宰殺，結果顯示血漿中leucine 和isoleucine 濃度SOS 組顯著較SOC 組為低，但此兩種氨基酸在FOC 與FOS 組間則無差異。血漿中 arginine 之濃度敗血症組不論是魚油或紅花子油組均較未敗血症組為低，血漿中 之glutamine 濃度則各組間並無差異，腹水中之細胞激素interleukin-1b, interleukin-6, tumor necrosis factor-a及leukotriene B4在FOS 組均有較SOS 組低之 趨勢，但未達統計上之差異性，此結果顯示與紅花子油相較，TPN 輸入魚油乳 劑有減輕敗血症引致之肌肉組織分解之情形，但對發炎反應相關的細胞激素的分 泌或發炎介質leukotriene B4 之分泌則並無影響。

The effect of preinfusing total parenteral nutrition (TPN) enriched with n-3 or n-6 fatty acids on plasma amino acid profiles, and inflammatory-related mediators was evaluated in septic rats. Thirty -two rats, with internal jugular catheters, were divided into two experimental groups and received TPN. TPN provided 300 kcal/kg/day with 40% of the non-protein energy provided as fat. All TPN solutions were isonitrogenous and identical in nutrient composition except for the fat emulsion, which was made of safflower oil (SO) or fish oil (FO). After receiving TPN for 7days, each experimental group was further divided into control and sepsis subgroups. Septic rats were induced by cecal ligation and puncture, whereas control rats received sham operation. The all rats were classified to four groups as follows: fish oil control group (FOC, n=7), fish oil sepsis group (FOS, n=8), safflower oil control group (SOC, n=8), safflower oil sepsis group (SOS, n=9). The results demonstrated that plasma leucine and isoleucine levels were significantly lower in the SOS group than in the SOC group, whereas no difference in these two amino acids was observed between the FOC and FOS groups. Plasma arginine levels were significantly lower in septic groups than in those without sepsis when either fish oil or safflower oil was infused. Plasma glutamine levels, however, did not differ among all groups. No significant differences in interleukin-1â, interleukin-6, tumor necrosis factor-á, or leukotriene B4 concentrations in peritoneal lavage fluid were observed between the 2 septic groups. These results suggest that, compared with safflower oil, TPN with fish oil emulsion did not have effects on inflammatory-related cytokines or leukotriene in peritoneal lavage fluid. Preinfusion with fish oil emulsion before sepsis, however, ameliorates the catabolic reaction of skeletal muscle in septic rats.