• 제목/요약/키워드: Improving liver function

검색결과 69건 처리시간 0.024초

Ginsenosides Rc, as a novel SIRT6 activator, protects mice against high fat diet induced NAFLD

  • Zehong Yang;Yuanyuan Yu ;Nannan Sun;Limian Zhou;Dong Zhang;HaiXin Chen ;Wei Miao ;Weihang Gao ;Canyang Zhang ;Changhui Liu ;Xiaoying Yang ;Xiaojie Wu ;Yong Gao
    • Journal of Ginseng Research
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    • 제47권3호
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    • pp.376-384
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    • 2023
  • Background: Hepatic lipid disorder impaired mitochondrial homeostasis and intracellular redox balance, triggering development of non-alcohol fatty liver disease (NAFLD), while effective therapeutic approach remains inadequate. Ginsenosides Rc has been reported to maintain glucose balance in adipose tissue, while its role in regulating lipid metabolism remain vacant. Thus, we investigated the function and mechanism of ginsenosides Rc in defending high fat diet (HFD)-induced NAFLD. Methods: Mice primary hepatocytes (MPHs) challenged with oleic acid & palmitic acid were used to test the effects of ginsenosides Rc on intracellular lipid metabolism. RNAseq and molecular docking study were performed to explore potential targets of ginsenosides Rc in defending lipid deposition. Wild type and liver specific sirtuin 6 (SIRT6, 50721) deficient mice on HFD for 12 weeks were subjected to different dose of ginsenosides Rc to determine the function and detailed mechanism in vivo. Results: We identified ginsenosides Rc as a novel SIRT6 activator via increasing its expression and deacetylase activity. Ginsenosides Rc defends OA&PA-induced lipid deposition in MPHs and protects mice against HFD-induced metabolic disorder in dosage dependent manner. Ginsenosides Rc (20mg/kg) injection improved glucose intolerance, insulin resistance, oxidative stress and inflammation response in HFD mice. Ginsenosides Rc treatment accelerates peroxisome proliferator activated receptor alpha (PPAR-α, 19013)-mediated fatty acid oxidation in vivo and in vitro. Hepatic specific SIRT6 deletion abolished ginsenoside Rc-derived protective effects against HFD-induced NAFLD. Conclusion: Ginsenosides Rc protects mice against HFD-induced hepatosteatosis by improving PPAR-α-mediated fatty acid oxidation and antioxidant capacity in a SIRT6 dependent manner, and providing a promising strategy for NAFLD.

헛개열매 간장의 알코올 분해 활성 및 관능적 품질 특성 (Alcohol Dehydrogenase Activity and Sensory Evaluation of Hutgae (Hovenia dulcis Thunb) Fruit Soy Sauce)

  • 정수영;임정섭;송희순
    • 한국식품영양학회지
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    • 제25권4호
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    • pp.747-754
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    • 2012
  • The objective of this study was to investigate free amino acid composition, antioxidant activity, alcohol dehydrogenase activity and the sensory quality attributes for the development of functional soy sauce using Hutgae (Hovenia dulcis Thunb) fruit, which is well-known for improving liver function and alleviating various negative physiological effects following heavy consumption of alcoholic beverages. Soy sauces adding six types of extract from Hutgae fruit (HF) were prepared (SSH1: HF 20%, SSH2: HF 10%, SSH3: HF 20%/40 days NaCl extract, SSH4: HF 20%/20 days NaCl extract, SSH5: HF 20% water bath extract, SSH6: freeze-drying powder from HF 20% aqueous extract), compared with soy sauce using the conventional method. These soy sauces were used for determining alcohol dehydrogenase activity by NADH absorbance, the antioxidant effect by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity and sensory evaluation by sensory scaling. Total free amino acid contents for most samples were in the range of 327.3 to 375.5 mg%, and then, aspartic acid and glutamic acid content of SSH1 and SSH5 were higher than that of others. DPPH radical scavenging activity was shown to be the highest in SSH4, also SSH1, SSH5 and SSF6 were shown to be higher than the control group. Alcohol dehydrogenase activity was shown to be the highest in SSH5. In sensory evaluation, the highest intensity of roast smell was observed in SSH4 while sweet taste was shown to be the highest in SSH5, and SSH3 and SSH5 revealed higher overall acceptability. From these results, Hutgae fruit soy sauces demonstrated antioxidant activity and alcohol dehydrogenase activity. In conclusion, soy sauces containing the water bath extract of Hutgae fruit may be used as a functional seasoning.

훈련방법의 차이가 SOD, Neutrophils 및 T세포에 미치는 영향 (The Effect of Different Type of Exercise on SOD, Neutrophils and T Lymphocytes)

  • 곽이섭;엄상용;김동은;황혜진
    • IMMUNE NETWORK
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    • 제5권4호
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    • pp.232-236
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    • 2005
  • Background: A physically active lifestyle and regular exercise training incurs many health benefits. One recently recognized benefit of regular moderate exercise is stress reduction and immune enhancement. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Methods: This study was undertaken to investigate the effect of different type of exercise on superoxide dismutase (SOD), neutrophils, and T lymphocytes of Sprague-Dawley rats. Sprague-Dawley rats were randomly divided into three groups; a non-Trained group (NTG, n=6), a swim-Trained group (STG), and a treadmill-Trained group (TTG). The exercise regimen was designed in a treadmill (5 times/5 days/week) during 8-weeks for TTG, and swim training (5 times/5 days/week) during 8-weeks for STG, and the volume of exercise training was the same in both groups. Results: 8 weeks of regular swim and treadmill training significantly increased liver SOD concentration however, muscle SOD concentration was not statistically significant. In the level of neutrophils, TTG and STG showed significant difference, compared to NTG. TTG was the highest level of neutrophils. In the level of immune cell counts, there was significant difference among TTG, STG, and NTG both in the spleen and thymus. Conculsion: In conclusion, it can be stated that eight weeks swim and treadmill exercise training has beneficial effect in improving immune response and antioxidant defence capacity by augmenting immune cells and SOD activities of SD rats.

천연 사료첨가제 Nattokinase 공급에 따른 젖소의 산유능력 및 혈액성상에 미치는 영향 (Effects of Feeding Nattokinase as Natural Feed Additives on Milk Production and Blood Metabolites in Lactating Dairy Cows)

  • 임동현;박중국;김현섭;기광석;이현준;권응기;;김창현;김상범
    • 한국유기농업학회지
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    • 제19권4호
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    • pp.553-563
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    • 2011
  • This experiment was conducted to determine the effect of nattokinase (NK) additives on milk production and composition, and blood metabolites in dairy cows. The two kinds of nattokinase with high fibrinolytic activity were produced by two strains of bacteria, Bacillus amyloliquefacines (NK1) and Bacillus subtilis (NK2). Total fifteen Holstein cows (average $1.83{\pm}0.37$ parity; average milk yield $23.2{\pm}3.2$ kg/d) were randomly assigned to three treatments (5 animals per treatment). Cows were fed TMR supplemented with 0g, 100g and 100g for control, NK1 and NK2 treatment, respectively for 4 weeks. Milk yield was significantly higher (p<0.05) for NK1 (22.89 kg/d) than for control (21.07 kg/d) and NK2 (21.36 kg/d). Somatic cell counts in NK treatments were significantly lower than that in control group (58,000 vs. 21,000 and 35,000 cells/ml, control vs. NK1 and NK2). Serum ALT levels in all treatment were similar to the range of 32.00~35.83 IU/L, but AST levels in NK1 (85.67 IU/L) was significantly decreased compared with those in control and NK2 (121.67 and 117.67 IU/L respectively). Serum T-CHO levels in NK1 (145.33 mg/dl) was significantly decreased (p<0.05) compared with that in control (179.00 mg/dl) and NK2 (176.17 mg/dl). This finding showed that NK1 additives could possibly have a positive effect in lactation performance of mid-lactation dairy cows by increasing milk yield, reducing somatic cell count, improving liver function and decreasing cholesterol in blood.

Efficacy of Korean Red Ginseng by Single Nucleotide Polymorphism in Obese Women: Randomized, Double-blind, Placebo-controlled Trial

  • Kwon, Dong-Hyun;Bose, Shambhunath;Song, Mi-Young;Lee, Myeong-Jong;Lim, Chi-Yeon;Kwon, Bum-Sun;Kim, Ho-Jun
    • Journal of Ginseng Research
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    • 제36권2호
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    • pp.176-189
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    • 2012
  • This study examined the effects of Korean red ginseng (KRG) on obese women and aimed to confirm that the effects of KRG on obesity differ dependently on a gene. Fifty obese women were recruited and randomized to receive KRG (n=24) or placebo (n=26) for 8 wk. Measurements of blood pressure, height, weight, waist circumference, waist-hip ratio (WHR), total fat mass, percentage of body fat, resting metabolic rate, basal body temperature, and daily food intake (FI), blood test (serum lipid, liver and renal function), Korean version of obesity-related quality of life scale (KOQOL), and a gene examination were performed. Comparisons of subjects before and after the administration of KRG revealed significant improvements of obesity in terms of weight, body mass index (BMI), WHR, FI, and KOQOL. However, in the comparison between KRG group and placebo group, only KOQOL was significantly different. KRG displayed significant efficacy on BMI and KOQOL in the CT genotype of the G protein beta 3 gene, but not in the CC genotype, on blood sugar test in the Trp64/Arg genotype of the beta 3 adrenergic receptor gene, but not in Trp64/Trp genotype, on KOQOL in the DD genotype of the angiotensin I converting enzyme gene, but not in the ID and DD genotypes. The effects of KRG on obesity were confirmed to some extent. However, a distinct effect compared to placebo was not confirmed. KRG is more effective for improving the secondary issues of the quality of life derived from obesity rather than having direct effects on the obesity-related anthropometric assessment and blood test indices.

편마비를 주소증으로 입원한 뇌경색 환자의 한방 치료 시기에 따른 치료 효과 분석 : 후향적 의무기록 분석 (Analysis of Treatment Effect According to the Period of Herbal Treatment in Cerebral Infarction Patients Admitted with Hemiplegia: Retrospective Medical Chart Review)

  • 최유진;김기태;신선미;고흥
    • 대한한방내과학회지
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    • 제40권4호
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    • pp.675-696
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    • 2019
  • Objective: This study was aimed at evaluating the effect and clarifying the treatment period of Korean medicine treatment for cerebral infarction. Method: This study was carried out on patients with hemiplegia who were hospitalized in the Department of Korean Internal Medicine of Jecheon Korean Medicine Hospital of Semyung University from June 2014 to May 2019. A retrospective study was performed on 253 patients who were diagnosed with cerebral infarction by brain CT or nuclear magnetic resonance imaging. Results and Conclusion: 1. Korean medicine treatment has a significant effect on improving the movement disorder and daily life independence of cerebral infarction. 2. In the group that started Korean medical treatment within one month after the onset of cerebral infarction, with the exception of MMSE-K, the indicators related to the movement disorder and daily life independence showed significant effect. 3. MMSE-K showed no statistically significant change in any of the patient groups. 4. Within three months after the onset date, the longer the period of treatment with Korean medicine, the better the symptom improvement of upper extremity movement disorder. 5. The longer the hospital stays, the better the symptom improvement of the lower extremity movement disorder. 6. The combination of Korean and Western medicine did not affect liver or kidney function.

고지방-콜레스테롤 식이 급이 흰쥐에 대한 동결건조 마늘분말의 지질개선 효과 (Effects of Freeze-Dried Garlic Powder on Lipid Improvement in Rats Fed a High Fat-Cholesterol Diet)

  • 강재란;강민정;변희욱;신정혜
    • 한국식품영양과학회지
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    • 제46권9호
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    • pp.1035-1044
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    • 2017
  • 고지방-콜레스테롤 식이를 급이시켜 고지혈증을 유도한 흰쥐에 4주 동안 매일 동결건조 마늘분말 5 mg/100 g BW(FGT-1)와 15 mg/100 g BW(FGT-2)를 보충 투여시켜 동결건조 마늘분말이 체내 지질대사에 미치는 영향을 확인하고자 하였다. FGT-1군과 FGT-2군의 최종체중, 체중증가량 및 식이효율은 고지방-콜레스테롤 급이군(HFC군)보다 유의적으로 낮았으며, 식이 섭취량은 모든 실험군에서 유의적인 차이가 없어 동결건조 마늘분말의 급이는 식이 섭취량에는 영향을 주지 않으면서 체중을 감소시켰다. 혈청 중 총 지질, 총 콜레스테롤 및 중성지질 함량은 FGT-1군과 FGT-2군이 대조군보다 유의하게 낮았다. 특히 총 지질 함량은 FGT-2군이 FGT-1군보다도 약 9% 더 낮았고 HFC군 보다는 약 12% 더 낮았다. 혈중 총 콜레스테롤은 고지방-콜레스테롤 식이 급이군에 비해 10% 이상, 중성지질은 37% 이상, LDL-콜레스테롤은 8% 이상 감소 효과가 있었고, 동맥경화지수 및 심혈관계 질환 위험지수 또한 유의적으로 낮았다. 혈중 간 기능 지표(ALP, AST 및 ALT)와 지질성분들은 FGT-1군과 FGT-2군이 HFC군보다 유의적으로 낮았다. 혈액의 TBARS 함량은 FGT-1군과 FGT-2군이 HFC군에 비해 각각 13.9%와 29.9% 더 낮았으며, 항산화 활성은 각각 약 1.4배와 2.2배 더 동결건조 마늘분말 급이군에서 높았다. 상기의 실험 결과들을 종합해보면 동결건조 마늘분말의 급이는 혈액 및 간장 내에서 HDL-콜레스테롤을 증가시키지는 못하지만 LDL-콜레스테롤과 중성지질의 농도를 저하시킴으로써 지질농도를 개선하는 효과를 가짐을 확인할 수 있었다. 동결건조 마늘분말의 급이는 혈액 및 간장 내 지질농도보다는 체내 지질과산화물의 생성을 억제하고, 항산화 활성을 높이는 데 더 큰 영향을 미쳤다. 이러한 생체 내에서 지질과산화 억제 및 항산화 효과는 동결건조 마늘분말의 급이에 따른 체내 지질농도 개선효과와 상승작용을 통해 동맥경화, 고지혈증 등과 같은 심혈관계 질환의 예방 및 개선에 기여할 것으로 기대된다.

Emodin의 항염 및 피부장벽개선 활성 연구 (Emodin Studies on Anti-inflammatory and Skin Barrier Improvement Activities)

  • 김세기;최재근;장영아
    • 한국응용과학기술학회지
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    • 제38권6호
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    • pp.1383-1392
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    • 2021
  • 호장근, 적하수오, 대황, 알로에 등과 같은 생약재의 주요 약리 활성 성분인 emodin은 항산화, 항균, 항염, 항암, 간보호 등에 효능이 있는 것으로 보고되었다. 본 연구에서는 emodin의 피부 질환 및 기능성 소재로서의 활용 가능성을 알아보기 위해 염증 개선과 피부장벽기능 개선 관련 활성을 확인하였다. human keratinocyte인 HaCaT 세포에 대하여 항염효과를 관찰하기 위해 cytokine억제능은 ELISA kit로, 단백질 발현은 western blot으로 확인하였다. TNF-α (10 ng/mL)/IFN-γ (10 ng/mL)로 활성화된 HaCaT 세포에서 emodin을 농도별(5, 10, 20, 40) µM로 처리한 결과 TNF-α, IL-1β 및 IL-6의 생성량은 emodin의 농도가 증가함에 따라 감소됨을 확인하였다. 염증관련 단백질인 iNOS, COX-2 발현량에 대한 실험결과에서도 emodin 20 µM 농도에서 control 대비 iNOS는 48%, COX-2는 29%가 저해됨을 확인하였다. 피부장벽기능 개선의 지표로써 filaggrin, involucrin, loricirn의 mRNA 발현 정도와 filaggrin, involucrin, loricirn의 생성량을 확인한 결과 에모딘 농도에 의존적으로 증가하는 우수한 결과가 얻어졌다. 특히 20 µM 농도에서 대조군 대비 2배의 생성량 증가를 보인 filaggrin은 천연보습인자인 NMF의 형성에 관계되는 단백질로 각질층의 보습에 중요한 역할을 하는 것으로 알려져 있다. 결론적으로 emodin의 피부 질환 및 기능성 소재로서의 활용 가능성 중 염증 개선 및 피부장벽기능 개선 소재로 활용될 수 있음을 확인하였으며 향후 추가적인 연구가 수행되면 그 활용 범위가 더 넓어질 수 있을 것으로 사료된다.

비증(痺證)에 대(對)한 최근(最近)의 제가학설(諸家學說) 연구(硏究) - 《비증전집(痺證專輯)》 에 대(對)한 연구(硏究) III - (The recent essay of Bijeung - Study of III-)

  • 양태훈;오민석
    • 혜화의학회지
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    • 제9권1호
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    • pp.513-545
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    • 2000
  • I. Introduction Bi(痺) means blocking. It can reach at the joints or muscles or whole body and make pains. Numbness and movement disorders. BiJeung can be devided into SilBi and HeoBi. In SilBi there are PungHanSeupBi, YeolBi and WanBi. In HeoBi, there are GiHyeolHeoBi, EumHeoBi and YangHeoBi. The common principle for the treatment of BiJeung is devision of the chronic stage and the acute stage. In the acute stage, BiJeung is usually cured easily but in the chronic stage, it is difficult. In the terminal stage, BiJeung can reach at the internal organs. BiJeung is one kind of symptoms making muscles, bones and jonts feel pain, numbness or edema. For example it can be gout or SLE etc. Many famous doctors studied medical science by their fathers or teachers. So the history of medical science is long. So I studied ${\ll}Bijeungjujip{\gg}$. II. Final Decision 1. BanSuMun(斑秀文) thought that BiJeung can be cured by blocking of blood stream. So he insisted that the important thing to cure BiJeung is to improve the blood stream. He usually used DangGuiSaYeokTang(當歸四逆湯), DangGuiJakYakSanHapORyeongSan, DoHong-SaMulTang(桃紅四物湯), SaMyoSanHapHeuiDongTang and HwangGiGyeJiOMulTang. 2. JangGeonBu(張健夫) focused on soothing muscles and improving blood seam. So he used many herbs like WiRyeongSeon(威靈仙), GangHwal(羌活), DokHwal(獨活), WooSeul(牛膝), etc. Especially he pasted wastes of the boiled herbs. 3. OSeongNong(吳聖農) introduced four rules to treat arthritis. So he usually used SeoGak-SanGaGam(犀角散加減), BoYanHwanOTang(補陽還五湯), ODuTang(烏頭湯), HwangGiGyeJiOMulTang. 4. GongJiSin thought disk hernia as one kind of BiJeung. And he said that Pung can hurt upper limbs and Seup can hurt lower limbs. He used to use GyeJiJakYakJiMoTang(桂枝芍藥知母湯). 5. LoJiJeong(路志正) introduced four principles to treat BiJeung. He used BangPungTang(防風湯), DaeJinGuTang) for PungBi(風痺), OPaeTang(烏貝湯) for HanBi(寒痺), YukGunJaTang(六君子湯) for SeupBi(濕痺) and SaMyoTang(四妙湯), SeonBiTang(宣痺湯), BaekHoGaGyeTang(白虎加桂湯) for YeolBi(熱痺). 6. GangChunHwa(姜春華) discussed herbs. He said SaengJiHwang(生地黃) is effective for PungSeupBi and WiRyungSun(威靈仙) is effective for the joints pain. He usually used SipJeonDaeBoTang(十全大補湯), DangGuiDaeBoTang(當歸大補湯), YoukGunJaTang(六君子湯) and YukMiJiHwanTang(六味地黃湯). 7. DongGeonHwa(董建華) said that the most important thing to treat BiJeung is how to use herbs. He usually used CheonO(川烏), MaHwang(麻黃) for HanBi, SeoGak(犀角) for YeolBi, BiHae) or JamSa(蠶沙) for SeupBi, SukJiHwang(熟地黃) or Vertebrae of Pigs for improving the function of kidney and liver, deer horn or DuChung(杜沖) for improving strength of body and HwangGi(黃?) or OGaPi(五加皮) for improving the function of heart. 8. YiSuSan(李壽山) devided BiJeung into two types(PungHanSeupBi, PungYeolSeupBi). And he used GyeJiJakYakJiMoTang(桂枝芍藥知母湯) for the treatment of gout. And he liked to use HwanGiGyeJiOMulTangHapSinGiHwan 枝五物湯合腎氣丸) for the treat ment of WanBi(頑痺). 9. AnDukHyeong(顔德馨) made YongMaJeongTongDan(龍馬定痛丹)-(MaJeonJa(馬錢子) 30g, JiJaChung 3g, JiRyong(地龍) 3g, JeonGal(全蝎) 3g, JuSa(朱砂) 0.3g) 10. JangBaekYou(張伯臾) devided BiJeung into YeolBi and HanBi. And he focused on improving blood stream. 11. JinMuO(陳茂梧) introduced anti-wind and dampness prescription(HoJangGeun(虎杖根) 15g, CheonChoGeun 15g, SangGiSaeng(桑寄生) 15g, JamSa(蠶絲) 15g, JeMaJeonJa(制馬錢子) 3g). 12. YiChongBo(李總甫) explained basic prescriptions to treat BiJeung. He used SinJeongChuBiEum(新定推痺陰) for HaengBi(行痺), SinJeongHwaBiSan(新定化痺散) for TongBi(痛痺), SinJeongGaeBiTang(新定開痺湯) for ChakBi(着痺), SinJeongCheongBiEum(新定淸痺飮) for SeupYeolBi(濕熱痺), SinRyeokTang(腎瀝湯) for PoBi(胞痺), ORyeongSan for BuBi(腑痺), OBiTang(五痺湯) for JangBi(臟痺), SinChakTang(腎着湯) for SingChakByeong(腎着病). 13. HwangJeonGeuk(黃傳克) used SaMu1SaDeungHapJe(四物四藤合制) for the treatment of a acute arthritis, PalJinHpPalDeungTang(八珍合八藤湯) or BuGyeJiHwangTangHapTaDeungTang(附桂地黃湯合四藤湯) for the chronic stage and ByeolGapJeungAekTongRakEum(鱉甲增液通絡飮) for EumHeo(陰虛) 14. GaYeo(柯與參) used HwalRakJiTongTang(活絡止痛湯) for shoulder ache, SoJongJinTongHwalRakTank(消腫鎭痛活絡湯) for YeolBi(熱痺), LiGwanJeolTang(利關節湯) for ChakBi(着痺), SinBiTang(腎痺湯) for SinBi(腎痺) and SamGyoBoSinHwan(三膠補腎丸) for back ache. 15. JangGilJin(蔣길塵) liked to use hot-character herbs and insects. And he used SeoGeunLipAnTang(舒筋立安湯) as basic prescription. 16. RyuJangGeol(留章杰) used GuMiGangHwalTang(九味羌活湯) and BangPungTang(防風湯) at the acute stage, ODuTang(烏頭湯) or GyeJiJakYakJiMoTang(桂枝芍藥知母湯) for HanBi of internal organs, YangHwaHaeEungTang(陽和解凝湯) for HanBi, DokHwalGiSaengTang(獨活寄生湯), EuiYiInTang(薏苡仁湯) for SeupBi, YukGunJaTang(六君子湯) for GiHeoBi(氣虛痺) and SeongYouTang(聖兪湯) for HyeolHeoBi(血虛痺). 17. YangYuHak(楊有鶴) liked to use SoGyeongHwalHyelTang(疏經活血湯) and he would rather use DoIn(桃仁), HongHwa(紅花), DangGui(當歸), CheonGung(川芎) than insects. 18. SaHongDo(史鴻濤) made RyuPungSeupTang(類風濕湯)-((HwangGi 200g, JinGu 20g, BangGi(防己) 15g, HongHwa(紅花) 15g, DoIn(桃仁) 15g, CheongPungDeung(靑風藤) 20g, JiRyong(地龍) 15g, GyeJi(桂枝) 15g, WoSeul(牛膝) 15g, CheonSanGap(穿山甲) 15g, BaekJi(白芷) 15g, BaekSeonPi(白鮮皮) 15g, GamCho(甘草) 15g).

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정맥영양 관련 간기능 장애에서 조기 주기성 정맥영양법의 유용성 (Early Management of Total Parenteral Nutrition Induced Hepatic Dysfunction with Cyclic Parenteral Nutrition)

  • 이성수;장주영;양혜란;고재성;최경희;서정기
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제7권1호
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    • pp.61-73
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    • 2004
  • 목 적: 담즙울체를 포함한 간기능 이상은 총정맥영양법을 시행받는 환자에게서 자주 나타나는 합병증 중 하나이며 이를 해소하기 위한 방법의 하나로서 주기성 정맥영양법이 있으나 소아에서는 이에 대한 연구가 미흡한 상태이다. 본 연구에서는 소아에서 총정맥영양법의 합병증으로 생긴 간기능 이상의 발생초기에 주기성 정맥영양법을 시행하여 그 유용성을 평가하고자 하였다. 방 법: 연구대상은 미숙아를 제외한 유소아로 총정맥영양법에 의한 담즙울체 및 간효소치의 증가를 보이고 혈역학적, 대사적으로 안정되었으며 주기성 정맥영양법이 간기능 이상을 보이는 초기에 시도되었던 12례의 환아들이었다. 주기성 정맥영양법의 중단시간은 3개월 미만에서는 2시간 이하, 그 이상에서는 4시간으로 하였다. 환아들의 의무기록지를 후향적으로 검토하였고 진단명, 지속성과 주기성 정맥영양법의 시행기간과 방법, 대사성 혹은 감염성 합병증 유무, 병행된 경관영양유무 및 정맥영양법을 시행하기 전후의 혈청 총 빌리루빈과 간효소치의 변화를 비교하였다. 결 과: 1) 환아들의 정중연령(median age)은 주기성 정맥영양법 시작시 4세(생후 2개월에서 17세)였고 기저질환은 만성가성장폐색증 4례를 비롯하여 다양하였다. 2) 동일 예에서는 대부분에서 투여된 단백과 포도당, 지방의 투여량에 차이가 없었다(p<0.05). 주기성 정맥영양법을 시행하는 동안 1례에서 잘 조절되지 않는 고혈당이 나타나 포도당의 감량이 필요하였으나 다른 대사성 및 정맥관의 감염과 관련된 합병증은 없었다. 3) 혈청 총빌리루빈은 총 5례에서 상승하였고 주기성 정맥영양법 시행 후 전 증례에서 정상화되었다(p<0.05). 주기성으로 전환시 혈청 빌리루빈은 3.6 mg/dL였으며 정상화된 때까지 걸린 기간은 8일이었다. 4) AST/ALT의 상승은 12례에서 모두 관찰되었고 주기성 정맥영양법 시행 후 전례에서 정상화되었다. 주기성으로 전환시 혈청 ALT는 200 IU/L였으며 주기성 정맥영양 시행 후 정상화된 때까지 걸린 기간은 34일이었다. 결 론: 저자들은 장기간의 총정맥영양법으로 인해 발생한 간기능 이상을 보인 유소아에서 주기성 정맥영양법으로의 조기전환이 효과적인 치료적 대안이 될 수 있으며 부작용이 적은 안전한 방법임을 관찰하였다. 향후 주기성 정맥영양법은 총정맥영양을 시행받는 소아들에서 간기능 이상을 방지하고 삶의 질을 높이기 위한 일차적인 방법으로 더욱 연구되어야 할 것으로 생각된다.

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