【摘要】 目的　前瞻性观察按不同比例摄入蛋白质、糖、脂肪三大营养素对大鼠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 2 1只 ,经行胃造瘘置管术后 ,造成背部 30 %深Ⅱ度烫伤模型 ,随机分为低脂低蛋白饮食组 (A组 )、高脂低蛋白饮食组 (B组 )和低脂高蛋白饮食组 (C组 )。实验动物营养摄入按 732kJ·kg- 1 ·d- 1 计算 ,3种营养配方均为等体积、等热卡 ,由恒量输液泵经造瘘管在 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 )水平、白细胞介素 2 (IL 2)水平、血浆白蛋白水平、血浆转铁蛋白水平、肝脏含氮量、空肠黏膜含氮量、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、创面组织羟脯氨酸含量和创面组织Ⅰ型和Ⅲ型胶原比例。　结果　烫伤后 10d,C组血浆白蛋白水平和肝脏含氮量均显著高于A组及B组 ;C组的脾淋巴细胞对ConA的反应性显著高于A组和B组 ,C组IL 2分泌水平显著高于A组 ,而C组腹腔巨噬细胞PGE2 的分泌水平显著高于A组和B组 ;C组创面组织羟脯氨酸含量显著高于A组 ,C组和B组的Ⅰ Ⅲ型胶原比例均显着低于A组 ,3组实验动物的血浆皮质醇水平、血浆胰高糖素水平以及尿香草扁桃酸含量比较 ,差异均无显著性意义 (P >0.0 5 )。　结?更多还原

【Abstract】 Objective To observe the effect of alteration of proportion of carbohydrate, protein and fat intake on the metabolic level, immunological function and healing of the burn wound. Methods Twenty-one SD rats were inflicted with 30% TBSA scalding on the back after the gastrostomy was performed on them. The rats were divided into three groups: i.e. group A(with low-fat and low-protein diet), group B(with high-fat and low-protein diet) and group C(with low-fat and high-protein diet). The intake caloric value was set at 732 kJ·kg -1 ·d -1 .Equal amounts of calories and volume for three groups were given in aconstant speed evenly with a pump within 24 hours through the tube inserted through the gastrostomy stoma. The response of splenic lymphocyte to ConA, the level of PGE2, IL-2, serum albumin, plasma transfferin, glucagon, and cortisol in blood, the content of hydroxyproline and the ratio of type I to type Ⅲ collagen in burn wounds , and the nitrogen content in the liver and the jejunal mucosa were measured ten days after injury. Results In group C, the level of serum albumin, the nitrogen content of the liver and the secretion of PGE2 from peritoneal macrophages were significantly higher than those in group A and B. The level of IL-2 in plasma and the content of hydroxyproline in burn wound of Group C was also significantly higher than that in group A, while the ratio of type l to type Ⅲ collagen in group B and C was significantly lower than that in group A. There were no significant differences among the three groups in the levels of plasma cortisol, glucagon and urine vanillylmandelic acid(VAM). Conclusion The low-fat and high-protein diet might be beneficial to the synthesis of protein, immunological function and the burn wound healing.更多还原