CAJ | 학술논문

目的研究添加丙氨酰谷氨酰胺(Ala-Gln)全胃肠外营养对烫伤大鼠的蛋白质代谢、肠粘膜形态学、创面肉芽组织的影响。方法将22只30%TBSAⅢ度烫伤SD大鼠行颈外静脉插管后，随机分为传统TPN组(传统组)和添加二肽TPN组(二伏组)，每组各11例，两组接受等热量(780kg.kg-1.d-1)等氮量(1.8N.kg-1.d-1，二肽组48%的氮量由Ala-Gln提供)TPN7天，每日留取24h尿测每日氮平衡和累积氮平衡；7天后取血作总蛋白(TP)、白蛋白(ALB)、前白蛋白(PAB)、转铁蛋白(TF)测定；高效液相检测肌肉中Gln的含量；观察空肠粘膜组织形态学和烫伤创面肉芽组织的情况。结果PAB、TF、肌肉Gln含量、二肽组明显高于传统组(P<0.01);7天的累积氮平衡、空肠粘膜绒毛高度、隐窝深度、绒毛表面积二肽组明显高于传统组，且差异有显著性(P<0.01)；创面肉芽组织中毛细血管和纤维母细胞数目二肽明显多于传统组(P<0.01)。结论烫伤大鼠应用添加Ala-Gln的胃肠外营养是有效的，能促进机体蛋白质合成，减轻蛋白质分解，改善空肠粘膜的组织结构，促进烫伤创面的愈合。
목적연구첨가병안선곡안선알(Ala-Gln)전위장외영양대탕상대서적단백질대사、장점막형태학、창면육아조직적영향。방법장22지30%TBSAⅢ도탕상SD대서행경외정맥삽관후，수궤분위전통TPN조(전통조)화첨가이태TPN조(이복조)，매조각11례，량조접수등열량(780kg.kg-1.d-1)등담량(1.8N.kg-1.d-1，이태조48%적담량유Ala-Gln제공)TPN7천，매일류취24h뇨측매일담평형화루적담평형；7천후취혈작총단백(TP)、백단백(ALB)、전백단백(PAB)、전철단백(TF)측정；고효액상검측기육중Gln적함량；관찰공장점막조직형태학화탕상창면육아조직적정황。결과PAB、TF、기육Gln함량、이태조명현고우전통조(P<0.01);7천적루적담평형、공장점막융모고도、은와심도、융모표면적이태조명현고우전통조，차차이유현저성(P<0.01)；창면육아조직중모세혈관화섬유모세포수목이태명현다우전통조(P<0.01)。결론탕상대서응용첨가Ala-Gln적위장외영양시유효적，능촉진궤체단백질합성，감경단백질분해，개선공장점막적조직결구，촉진탕상창면적유합。
Objective To study the effect ofalanyl-glutamine(Ala-Gln)supplemented total prenteral nutrition (TPN) on peotein metabolism,intestinal mucosal morphology,granulation tissues on wound in burned rats. Method Twenty-two SD rats that were placed a central venous catheter and subjccted to 30% TBSA Ⅲ° burn were divided into two groups equally:conventional TPN group (control group)and Ala-Gln supplemented TPN group (Ala-Gln group) and Ala-Gln supplemented TPN group (Ala-Gln group).All rats received isocaloric (780kJ.kg-1.d-1) and isonitrogenous (1.8g.kg-1.d-1,48% of nitrogen was supplied with Ala-Gln in Ala-Gln group) TPN for 7 days.Nitrogen balance and cumulated nitrogen balance were monitored.At the end of TPN,serum total protein (TP),albumin (ALB),prealbumin (PAB),transferrin (TF),Gln in muscle were monitored;Jcjunal mucosal morphology and granulation tissues on wound were observed. Results serum PAB,TF,Gln in muscle in Ala-Gln group were significantly higher than those in control group (P<0.01);Ala-Gln supplemented TPN significantly increased jejunal villus height,crypt depth,mucosal thickness and villous surface area compared with conventional TPN(P<0.01);The density of capillary vessels and fibroblast in the granulation tissues in Ala-Gln group were significantly highermore than those in control group (P<0.01). Conclusion Ala-Gln supplemented TPN in burned rats may promote protein anabolism,attenuate protein catabolism,maintain intestinal mucosal structure,promote wound healing.