【摘要】 目的　评估烫伤后大鼠胃肠营养支持中强化精氨酸、亚麻酸多不饱和脂肪酸 (ω 3PUFA)、谷氨酰胺对烧伤后营养代谢水平、免疫功能和创面愈合的作用。　方法　SD大鼠 30只 ,行胃造瘘置管术后 ,造成深Ⅱ度烫伤的动物模型 ,随机分为两组。A组给予热卡比为蛋白质 2 5 %、脂肪12 %、碳水化合物 6 3%的低脂高蛋白饮食 ;B组在此基础上强化精氨酸、ω 3PUFA及谷氨酰胺。实验动物的营养摄入按 175kcal·kg-1·d-1(1kcal=4 .184kJ)计算 ,2种营养配方均为等体积、等热卡、等氮量 ,在 2 4h内均匀输入。于伤后 10d检测脾淋巴细胞对刀豆蛋白A(ConA)的反应性、前列腺素E2(PGE2 )、白细胞介素 2 (IL 2 )、血浆白蛋白、血浆转铁蛋白、肝脏含氮量、空肠粘膜含氮量、血浆皮质醇水平、血浆胰高血糖素水平、2 4h尿香草扁桃酸含量 (VMA)、创面组织羟脯氨酸含量和创面组织Ⅰ型和Ⅲ型胶原比例 ,并于不同时相点观察体重的变化、皮肤迟发型超敏反应程度和创面愈合时间。　结果　B组血浆白蛋白水平、肝脏含氮量以及空肠粘膜含氮量显著高于A组 (P <0 .0 5 ) ,两组体重变化以及血浆皮质醇、血浆胰高血糖素和VMA含量差异均无显著性意义 (P >0 .0 5 ) ;B组脾淋巴细胞对ConA的反应性以及伤后 14d皮肤迟发型超敏反应显著高于A组 (P <0 .0 5更多还原

【Abstract】 Objective To evaluate the effects of postburn dietary supplementation of arginine(Arg), ω-3 polyunsaturated fatty acid(ω 3PUFA) and glutamine(Glu) on the metabolism , immunology and wound healing in scalded rats. Methods Thirty Sprague Dawley (SD) rats inflicted with 30% total body surface area deep partial thickness scald on the back after the gastrostomy catheter was placed were employed as the model . The rats were randomly divided into A and B groups,and all of them received continuous isonitrogenous (25% protein, 12% fat, 63% carbohydrate), isocaloric (175 kcal/kg/day ), and isovolemic intragastric tube feedings. The contents of Arg ,ω 3PUFA, Glu in the dietary of B group were enriched. The parameters were measured on the 10th day after injury,including the response of spleen cells to ConA, the plasma levels of PGE 2, IL 2, albumin, transferrin ,glucagons, cortisol in blood, the urinary content of vanillylmandelic acid(VAM) in 24 hour urine , the content of hydroxyproline, the ratio of type I to type Ⅲ collagen in burn wounds , and the nitrogen content in the liver and in the jejunal mucosa, as well as the weight changes, skin delayed hypersensitivity test,and wound healing time. Results It was revealed that the serum level of albumin , the nitrogen content in the liver and in the jejunal mucosa were obviously higher in B than those in A group. At the same time, there was no statistical difference in the plasma levels of cortisol and glucagons and urinary content of VAM between the two groups ,nor in body weight changes. Meanwhile, the response of spleen cells to ConA and the skin delayed hypersensitivity induced by DNFB 14 days after injury in group B were also enhanced compared with those in group A. Although the expression of PGE2 from peritoneal macrophages was lower , the content of hydroxyproline from burn wounds in group B was significantly higher than that in group A, and the ratio of type l to type Ⅲ collagen in group B was significantly lower than that in group A. Compared with group A, the wound healing time in group B was significantly shortened (P< 0.05). Conclusion The low fat and high protein feeding diet with enriched arginine,ω 3 PUFA , glutamine could benefit the nutritional status after burn injury, thus improve the immunological function and promote wound healing. [更多还原