【摘要】 目的:观察肠内营养(EN)对重症急性胰腺炎(SAP)大鼠糖皮质激素受体(GR)和热休克蛋白70(Hsp70)的变化及其影响。方法:采用逆行肝胰管注射牛磺胆酸钠造成SAP模型。将60只大鼠随机分成肠外营养(PN)组,(n=25)、EN组(n=25)和对照组(n=10)。PN和EN分别采用经右颈外静脉置管输液和经胃造口空肠上段给营养液的方法。各组建模成功后,均应用奥曲肽皮下注射作基础治疗。于第5天各组分别处死5只大鼠、第10天分别处死全部存活大鼠,观察胰腺、肝、肾、肺和小肠的病理改变,并采用蛋白印迹法测定各组织的GR和Hsp70含量,观察每组第5天和10天的累积病死率。结果:①PN组和EN组大鼠各时段各组织的GR水平明显低于对照组(P<0.01)、Hsp70明显高于对照组(P<0.01~0.05);②除肾外,EN组大鼠各时段各组织的GR和Hsp70含量明显高于PN组(P<0.01~0.05);③对照组大鼠各时段胰腺、肝、肾、肺和小肠的病理检查基本正常,PN组和EN组各时段上述组织存在明显的病理改变,EN组的病理改变较PN组明显减轻;④EN组大鼠第10天的生存率略高于PN组。结论:在重症急性胰腺炎大鼠模型中,可见GR水平降低和Hsp70水平升高,EN能改善SAP大鼠的组织损害,提高其生存率。更多还原

【Abstract】 Objective:To evaluate the effects of enteral nutrition on glucocorticoid receptor(GR) and heat shock protein 70(Hsp70) in severe acute pancreatitis(SAP) in rats.Methods: The model of SAP was established by retrograde injection of sodium taurocholate solution into the pancreatic duct.60 rats were randomized into SAP treated by parenteral nutrition group(PN group,n=25),SAP treated by enteral nutrition group(EN group,n=25) and control group(n=10).The rats were killed 5 or 10 days,and pancreas,liver,kidney,lung and small intestine were examined.The contents of GR and Hsp70 in tissue were assayed by western blotting.Results: ① In PN ang EN groups,the contents of GR in tissue were lower and the contents of Hsp70 were higher than in control group at different time points;②In EN group,the contents of GR and Hsp70 were higher than that in PN group(except kidney);③ Significant pathological alterations were found in pancreas,liver,kidney,lung and small intestine in all rats,and the pathological alteration in PN group was more severe than that in EN group;④The mortality of rats in EN group was higher than those in PN group.Conclusion: The contents of GR may decrease and the contents of Hsp70 may increase in rats with severe acute pancreatitis,and the enteral nutrition can reduce the pathological alterations of tissues and increase the mortality.更多还原