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早期肠内营养支持对犬重症急性胰腺炎肠道屏障功能的影响

Effect of early enteral nutrtion on the barrier function of the gut in dogs with severe acute pancreatitis

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【作者】 秦环龙苏振东高琦林擎天

【Author】 QIN Huan long, SU Zhen dong, GAO Qi, LIN Qing tian (Department of Surgery,Shanghai Sixth People’s Hospital,Shanghai 200233,China)

【机构】 上海市第六人民医院外科上海市第六人民医院外科 上海200233上海200233上海200233

【摘要】 目的 :观察早期肠内营养 (EEN)对犬重症急性胰腺炎 (SAP)肠道粘膜结构、功能及细菌、内毒素移位的影响。 方法 :在麻醉状态下 ,进腹向胰管内注入 5 %牛磺胆酸钠混合液 1ml/kg诱导SAP。 1 5只杂种犬SAP分为肠外营养 (PN)组和EEN组。EEN组在诱导SAP后 2 4h采用EN ,维持 5天。在实验前、后 1、4、7天测定外周血内毒素 (ET)。实验结束 ,取门静脉血测定ET ;取肠系膜淋巴结、肺门以及肺组织、胰腺和门静脉血作细菌培养。测定小肠、结肠蛋白质和DNA含量 ,并作粘膜形态学观察。 结果 :EEN组外周血及门静脉血ET和各脏器中细菌含量均低于PN组 ,P <0 .0 5 ;小肠和结肠肠壁蛋白质、DNA含量、绒毛高度、粘膜及全层厚度均明显高于PN组 ,P <0 .0 5。 结论 :EEN有助于防止犬SAP肠粘膜萎缩及细菌移位。

【Abstract】 Objectives:To evaluate the effect of early enteral nutrition(EEN) on the structure and function of the gut, the bacterial and endotoxin translocation. Methods:SAP model was induced by injecting 1 ml/kg of combined solution of 5% sodium taurocholate and trypsin into the pancreas via pancreatic duct.15 dogs were divided into PN group and EEN group.Systemic plasma endotoxin levels was quantified.Both portal and systemic blood sample were obtained before and 1?4?7 d following SAP,and cultured for aerobic as well as anaerobic bacterial growth.Specimens of tissue from mesentery lymph nodes,lung and pulmonary portal nodes and pancreas were removed,weighed and homogenized at the 7th day. Results:The levels of systemic plasma endotoxin and the magnitude of bacterial translocation to the portal and cycle blood and distant organs were significantly reduced the protein and DNA content of the small intestine and colon increased,and the height of the villi and the thickness of mucosa and whole bowel wall of the intestinel and colon improved in EEN group as compared with those in PN group. Conclusions:We conclude that EEN can improve gut metabolism,decrease the extent of mucosal atrophy,and assist in the maintenance of the mucosal barrier function.It is effective touse EEN in severe acute pancreatitis.

【基金】 上海市青年科技启明星计划基金资助课题(99QB14 0 10 )
  • 【文献出处】 肠外与肠内营养 ,Parenteral & Enteral Nutrition , 编辑部邮箱 ,2002年01期
  • 【分类号】R459.3
  • 【被引频次】52
  • 【下载频次】156
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