醋酸盐点滴液与葡萄糖醛酸甜菜碱对于犬急性肝损伤之疗效评价.doc

醋酸鹽點滴液與葡萄糖醛酸甜菜鹼 對於犬急性肝損傷之療效評估 The treatment effects of betaine glucuronate and balanced polyionic solutions of acetate on the acute hepatic damage in dogs 研究生：曾富翊 Zeng, Fu-Yi 指導教授：杜杰憲 Tu, Chieh-Hsien 【摘要】 臨床上，有許多罹患急性肝病之病畜，如果及時進行治療，藉由肝臟之再生能力仍可回復正常肝功能。本研究之目的在探討三種肝臟治療法對於四氯化碳誘發急性肝損傷之療效。十六隻健康實驗犬隨機分成四組，每組四隻，以口服四氯化碳誘發急性肝損傷後，分別進行（1）對照組不予治療，（2）每日定時靜脈注射葡萄糖醛酸甜菜鹼（Jetepar?）治療，（3）每日持續靜脈輸液醋酸鹽點滴液（南光一號?， NK）治療，（4）持續靜脈輸液NK併用Jetepar?等四組治療。治療前後觀察實驗犬之臨床狀況，如精神食慾之狀態、排便之情形，同時從血清生化學評估肝臟損傷程度，監測項目有氨基丙酸轉氨酶 （ALT）、天門冬酸鹽轉氨酶（AST）、鹼磷酶（ALP）、總膽紅素（TB）及白蛋白（Albumin）等。對照組、Jetepar?組、NK組、和NK併用Jetepar?組之ALT，由最高值減少至一半所需時間 ( T1/2 ) 分別為6.20±0.49、4.92±0.22 ( p 0.05 )、4.93±0.20 ( p 0.05 ) 和4.72±0.41天 ( p = 0.011 )。由以上結果推論Jetepar?對於犬急性肝損傷具有療效，然而併用Jetepar?和靜脈輸液之治療方式療效較佳。 關鍵字：犬、四氯化碳、葡萄糖醛酸甜菜鹼、急性肝損傷 【Abstract】 Many cases of hepatic failure are reversible if short-term appropriate support is provided. The purpose of this study was to evaluate the treatment effect of the three methods on carbon tetrachloride（CCl4）-induced acute hepatic injury in dogs. Sixteen healthy dogs were divided randomly into four groups with four animals each. All the groups were received medical treatment except the control. Betaine glucuronate ( Jetepar? ) was administered intravenously once a day at the dose of 75 mg/kg. Intravenous fluid therapy with balanced polyionic solutions of acetate ( Nako No.1?；NK ) was infused constantly with and without Jetepar?. The general clinical condition of the experimental dogs such as mental status, appetite, urination, and defecation were observed in the peri-treating period. Serum biochemical test related with hepatic injury including enzyme activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and concentration of total bilirubin (TB) and albumin were periodically performed. Plasma half time (T1/2) of ALT maximal activity in control, Jetepar, NK and Jetepar + NK group were 6.20±0.49, 4.92±0.22 ( p 0.05 ), 4.93±0.20 ( p 0.05 ), an