Comparison of pH Modified Total Parenteral Nutrition Solution in Affecting Metabolism and Acid-base Homeostasis in Parenterally Fed Rats

比較不同酸鹼值的全靜脈營養輸液對大鼠代謝作用及酸鹼平衡之影響

羅慧珍(Hui-Chen Lo) ； 蔡馥安(Fu-Ann Tsai) ； 王淑惠(Shu-Hui Wang)

《中華民國營養學會雜誌》 26卷2期 (2001/06) Pp. 77-88

https://doi.org/10.6691/JCNS.200106_26(2).0002

摘要

長期使用全靜脈營養(TPN)輸液的病人可能因輸入酸性物質而造成代謝性酸中毒。本實驗的目的在探討TPN輸液酸鹼值(pH)對代謝反應及酸鹼平衡之影響。雄性Wistar大鼠（約250公克重）經頸靜脈插管（第0天）後，輸予12天以鹽酸或氫氧化鈉調整pH值至4.5或6.5，或未經調整（pH5.5）的TPN輸液。大鼠又分為注射saline（TPN模式）或dexamethasone以誘發異化（DEX模式）之兩種模式。結果顯示TPN模式中，施予pH6.5 TPN輸液之大鼠，體重流失量、心臟、肝臟及脾臟相對重量（克重／公斤體重）及血液白血球數目，顯著較施予pH5.5 TPN輸液之大鼠增加；氮平衡、血紅素含量、血色素含量、碳酸氫鹽、白蛋白及類胰島素生長因子-1則顯著降低。在DEX模式中，各組間生長反應無著差異，但施予pH4.5 TPN輸液之大鼠，血清三酸甘油酯較施予pH5.5 之TPN輸液，可能造成正常大鼠之異化作用及酸鹼平衡失調，而鹽酸調整pH值至4.5之TPN輸液，可造成注射dexamethasone之大鼠其代謝性失調。

關鍵字

全靜脈營養輸液 ； 酸鹼值 ； 代謝作用 ； 酸鹼平衡

並列摘要

Patients who received long-term total parenteral nutrition (TPN) solution are possibly affected by metabolic acidosis due to the acid load from the TPN solution. The objective of this study was to determine if a pH modified TPN solution would alter the metabolism and acid-base homeostasis in vivo. Male Wistar rats (～250 g), subjected to jugular vein cannulation (day 0), were infused with hydrochloric acid-acidified (pH 4. 5), sodium hydroxide-alkalized (pH 6, 5), or conventional (pH 5. 5) TPN solution for 12 days. A normal parenterally fed rat model (TPN model) and a dexamethasone-induced catabolic rat model (DEX model) were tested. Our results showed that alkalized but not acidified TPN solution significantly increased weight loss, relative weights of heart, liver, and spleen (g/kg body weight), and the circulating members of white blood cells in the TPN model. In addition, nitrogen retention, red blood cells, hemoglobin, bicarbonate, albumin, and insulin-like growth factor-I levels were significantly decreased in rats with alkalized TPN solution compared to rats with traditional TPN solution. In contrast, there was no significant difference in growth response among the groups in the DEX model. However, DEX-treated animals infused with acidified TPN solution showed significantly greater serum level of triglyceride and lower relative lung weight than those infused with traditional TPN solution. Our results suggest that sodium hydroxide-alkalized (pH 6. 5) TPN solution may induce catabolism and acid-base imbalance in normal rats. However, hydrochloric acid-acidified (pH 4. 5) TPN solution may induce metabolic disorders in dexamethasone-treated rats.

並列關鍵字

total parenteral nutrition ； pH values ； metabolism ； acid-base balance