全靜脈營養輸液添加精胺酸及N(上標 G)-monomethyl-L-arginine對腹膜炎大鼠代謝作用的影響

Effects of Arginine and N(superscript G)-Monomethyl-L-arginine Supplemented Total Parenteral Nutrition on Metabolism in Rats with Peritonitis

羅慧珍(Hui-Chen Lo) ； 蔡馥安(Fu-Ann Tsai) ； 林靜怡(Ching-Yi Lin)

《中華民國營養學會雜誌》 30卷1期 (2005/06) Pp. 12-20

https://doi.org/10.6691/JCNS.200506_30(1).0002

摘要

研究證實精胺酸具有增加手術及燒傷患者蛋白質合成的作用。然而亦有研究指出，患者受到感染時，精胺酸經一氧化氮合成酶(NOS)作用大量產生一氧化氮(NO)，進而引發敗血症。因此，本實驗探討同時補充精胺酸及NOS抑制劑對發炎反應與代謝作用的影響。雄性Wistar大鼠以盲腸穿孔手術誘發腹膜炎，並經頸靜脈插管輸予添加精胺酸（ARG組）、NOS抑制劑（N(上標G)-monomethyl-L-arginine, MMA組）、精胺酸與NOS抑制劑（COM組）、或傳統的全靜脈營養(TPN)輸液（CPP組）。對照組則未誘發腹膜炎，但輸予傳統TPN輸液（TPN組）。實驗共進行三天。結果顯示ARG及COM組的血清尿素氮濃度顯著高於TPN及CPP組；MMA及COM組血清GOT及GPT濃度顯著高於TPN組。腹膜炎大鼠血清胰島素、間白素(IL)-6及NO濃度顯著高於TPN對照組，而給予同時添加精胺酸及L-NMMA的TPN輸液中顯著增加血清胰島素及IL-6濃度；給予單獨添加精胺酸的TPN輸液則顯著減緩IL-6的增加。此外，添加精胺酸顯著增加血漿精胺酸及鳥胺酸濃度，但未顯著改變瓜胺酸濃度。本實驗結果建議添加精胺酸的TPN輸液具有減緩發炎反應的作用，但同時添加精胺酸及L-NMMA並無法改善腹膜炎大鼠的高度代謝及發炎反應。

關鍵字

全靜脈營養 ； 精胺酸 ； 一氧化氮 ； L-NMMA ； 腹膜炎 ； 代謝作用

並列摘要

It has been demonstrated that arginine increases the protein synthesis in surgical and burned patients. However, in patients with infection, nitric oxide synthase (NOS) catalyzes arginine to produce excess nitric oxide (NO) that results in the development of sepsis. Therefore, w investigated the effects of simultaneous administration of arginine and NOS inhibitor on inflammatory and metabolic responses. Male Wistar rats underwent cecal puncture for the introduction of peritonitis and jugular vein cannulation for the infusion of total parenteral nutrition (TPN) solution, supplemented with arginine (ARG group), NOS inhibitor (N(superscript G)-monomethyl-L-arginine, MMA group), or arginine plus NOS inhibitor (COM group) or conventional TPN solution (CPP group). A non-peritonitic group infused with conventional TPN solution (TPN group) was also included. The experiment was exerted for three days. The ARG and COM groups had significantly increased blood urea nitrogen compared to the TPN and CPP groups. The MMA and COM groups had significantly increased serum concentrations of GOT and GPT compared to the TPN group. Animals with peritonitis had significantly increased serum concentrations of insulin, interleukin (IL)-6, and NO compared to those without peritonitis. Simultaneous administration of arginine and L-NMMA further augmented the peritonitis-induced increases in serum insulin and IL-6, whereas administration of arginine alone significantly attenuated the increase in IL-6. Moreover, arginine administration, with or without L-NMMA, significantly increased serum concentrations of arginine and ornithine, but not citrulline. Our results suggest that arginine may attenuate the inflammatory response, but simultaneous administration of arginine and L-NMMA may not improve the hypermetabolic and inflammatory responses in rats with peritonitis.

並列關鍵字

total parenteral nutrition ； arginine ； nitric oxide ； L-NMMA ； peritonitis ； metabollsm