摘要
目的探讨不同营养物质及支持途径对肠道缺血再灌注大鼠肠屏障功能和细菌易位的影响。方法60只雄性SD大鼠建立肠道缺血再灌注模型,随机分成普通肠外营养组(PN),富含谷氨酰胺的肠外营养组(G-PN),普通肠内营养组(EN)及免疫增强型肠内营养组(IEN)。从术后第1天起连续营养支持7d,各组等氮、等热卡。观察肠道形态学、肠道黏膜通透性、肠道细菌易位情况和血浆内毒素水平及肠道免疫功能检测。结果PN组肠黏膜明显萎缩,其绒毛高度、黏膜厚度、隐窝深度及绒毛表面积均显著低于其他各组(P<0.05);其肠黏膜通透性及内毒素值显著高于其他各组(P<0.05),细菌易位率(100%)明显高于其他各组(G-PN组60.0%,EN组33.3%,IEN组20.0%)。PN组CD4+T淋巴细胞和IgA+浆细胞分布显著低于其他各组(P<0.01)。结论EN在维护肠黏膜屏障功能、防止细菌及内毒素易位方面优于PN。免疫增强型EN在维护肠黏膜屏障、改善肠道免疫功能、防止细菌易位方面作用优于普通EN。
Objective To evaluate the influence of different nutritional support routes and nutrients on the intestinal barrier function and bacterial translocation in rats with gut ischemia/reperfusion(I/R) injury. Methods Gut I/R injury was made in sixty male Sprague Dawley rats. The rats were divided randomly into four groups with fifteen animals in each group: parenteral nutrition (PN),Gln enriched TPN (G PN),enteral nutrition (EN),and enteral immunonutrient (IEN) groups,and received isocaloric and isonitrogenous nutrition support for seven days. The intestinal morphology,permeability of intestinal mucosa,bacterial translocation and gut immune barrier function were compared. Results Mucosal thickness,villous height,crypt depth and villous surface area in PN group decreased significantly compared with the other groups (P< 0.05). The incidence of intestinal bacterial translocation was significantly higher in PN group than those in the other groups(PN group 100%,G PN group 60.0%,EN group 33.3%,IEN groups 20.0%)(P< 0.05). The values of D lactate and endotoxin levels were remarkably higher in PN group than those in the other groups (P< 0.05). CD4+,CD4+/CD8+,and IgA containing B cells in G PN,EN and IEN groups were higher than that in PN group (P< 0.01). Conclusions TPN alone can result in intestinal mucosa atrophy,impair gut immune barrier function,and therefore facilitate bacterial and endotoxin translocation. Immunonutrition can significantly benefit gut barrier function and prevent enterogenic infection.
出处
《中华胃肠外科杂志》
CAS
2004年第6期499-502,共4页
Chinese Journal of Gastrointestinal Surgery
关键词
缺血再灌注
通透性
细菌易位
肠外营养
肠内营养
免疫营养
Ischemia/reperfusion
Permeability
Bacterial translocation
Nutrition, parenteral
Nutrition,enteral
Immunonutrition
