【摘要】 目的 :探讨早期肠内营养联合重组人生长激素对严重烫伤大鼠血清内毒素及TNFα影响。方法 :成年健康wistar大鼠 130只 ,随机分为正常组 (N)、伤后对照组 (C)、早期肠内营养组 (EEN)及早期肠内营养 +重组人生长激素组 (EEN +rhGH)。C组、EEN组、EEN +rhcGH组均给予 30 %TBSAⅢ°背部烫伤 ,分为伤后第 1、3、5、9天四个时相点 ,烫伤后C组大鼠自由进食饲料 ,EEN组及EEN +rhGH组大鼠灌喂牛奶 ,EEN组大鼠每晚皮下注射生理盐水 0 .1ml,EEN +rhGH组大鼠每晚皮下注射重组人生长激素 0 .3U kg。于各时相点活杀取血 ,分离血清 ,测定内毒素、TNFα含量。结果 :(1)烫伤后各组大鼠血清内毒素水平较伤前正常组 (N组 )显著上升 ,EEN组、EEN +rhGH组大鼠血清内毒水平在各时相点低于C组 ,EEN +rhGH组大鼠血清内毒素水平在各时相点低于EEN组 ;(2 )各组大鼠血清TNFα水平较伤前正常组 (N组 )显著上升 ,EEN组大鼠血清TNFα水平在各时相点低于C组 ,EEN +rhGH组血清TNFα水平在各时相点低于EEN组。结论 :严重烧伤后 ,早期肠内营养可以降低内毒素及TNFα水平 ,早期肠内营养联合重组人生长激素作用于优于单纯早期肠内营养更多还原

【Abstract】 Objective: To evaluate the effect of early enteral nutrition(EEN)with recombinant human growth hormone(rhGH)on serum endotoxin and serum TNFα level in severely scalded rats. Methods: One hundrad thirty wistar rats were randomly divided into four groups as normal(N),control(C),early enteral nutrition(EEN),and early enteral nutrition with rhGH(EEN+rhGH). The rats in groups C,EEN and EEN+rhGH were inflicted with 30% TBSA Ⅲ degree scalding on the back and the indices were observed on 1,3,5,9 postburn day(PBD).Equal amount of calories were applied via free feeding to those in N and C groups or compulsory early enteral feeding to those in EEN and EEN+rhGH groups.The scalded rats were administered subcutaneously with normal saline(0.1 ml/d)and rhGH(0.3 u/kg.d)every evening,in EEN and EEN+rhGH groups,respectively.The changes of serum endotoxin and serum TNFα were observed.Results:(1)The levels of serum endotoxin in C,EEN,and EEN+rhGH groups were higher than that in N group( P <0.01).The Serum levels of endotoxin in EEN and EEN+rhGH groups were lower than that in C group( P )<0.01),and the serum levels of endotoxin in EEN+rhGH groups were lower than that in EEN group.(2)The serum level of TNFα in EEN group was lower than that in C group( P <0.01).The serum level of TNFα in EEN+rhGH group was lower than that in both C group( P <0.01)and EEN group( P <0.05～0.01).Conclusion:Early enteral nutrition could decrease the levels of endotoxin and TNFα in burn, and the effect of EEN with rhGH would be better than that of EEN alone.更多还原