中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2008年
3期
163-166
,共4页
陈磊%邹晓平%田觅%顾超
陳磊%鄒曉平%田覓%顧超
진뢰%추효평%전멱%고초
胰腺炎,急性坏死性%肠内营养%肠外营养%肠道黏膜
胰腺炎,急性壞死性%腸內營養%腸外營養%腸道黏膜
이선염,급성배사성%장내영양%장외영양%장도점막
Pancreatitis,acute necrotizing%Enteral nutrition%Parenteral nutrition%Intestinal mucosa
目的 观察肠内免疫微生态营养(EIN)对重症急性胰腺炎(SAP)模型猪肠道屏障功能的影响.方法 家养猪20头注入5%牛磺胆酸钠和胰蛋白酶建立SAP模型.24 h后将18头成功造模猪均分为肠外营养(PN)组、肠内要素营养(EEN)组和EIN组,分别进行相应营养支持8 d.分别于造模前、后各时间点检测各组血淀粉酶、外周血内毒素及肠道通透性.8 d后处死动物取外周静脉血、胰、脾、肝、肺和肠系膜淋巴结进行细菌定性及定量检测,同时观察回肠末端黏膜形态及胰腺组织病理学改变并作病理评分.结果 各组血淀粉酶均明显升高,但组间比较差异无统计学意义(P＞0.05).营养8 d后EIN组外周血内毒素为(1.50±0.18)EU/L,肠道通透性为(42.8±20.0)×10-3,明显低于EEN组[(1.98±0.20)EU/L,(67.4±23.0)×10-3]和PN组[(3.96±0.40)EU/L,(197.2±47.4)×10-3](P值均＜0.05).EIN组胰腺和远隔脏器细菌数及细菌移位率亦明显低于PN组和EEN组(P＜0.05);三组间胰腺病理评分差异无统计学意义(P＞0.05).EIN组小肠绒毛高度、隐窝深度、黏膜厚度和绒毛形态正常率分别为(398.27±52.93)μm、(269.72±41.66)μm、(681.98±58.33)μm和79%,EEN组分别为(305.70±42.72)μm、(1 92.52±38.17)μm、(507.31±68.23)μm和47%,PN组分别为(218.32±35.81)μm、(145.76±23.34)μm、(376.20±48.23)μm和13V0,EIN组以上指标值均高于EEN组和PN组(P值均＜0.05).结论 EIN能保护SAP猪肠道屏障功能,降低肠道通透性,减少细菌及内毒素移位.
目的 觀察腸內免疫微生態營養(EIN)對重癥急性胰腺炎(SAP)模型豬腸道屏障功能的影響.方法 傢養豬20頭註入5%牛磺膽痠鈉和胰蛋白酶建立SAP模型.24 h後將18頭成功造模豬均分為腸外營養(PN)組、腸內要素營養(EEN)組和EIN組,分彆進行相應營養支持8 d.分彆于造模前、後各時間點檢測各組血澱粉酶、外週血內毒素及腸道通透性.8 d後處死動物取外週靜脈血、胰、脾、肝、肺和腸繫膜淋巴結進行細菌定性及定量檢測,同時觀察迴腸末耑黏膜形態及胰腺組織病理學改變併作病理評分.結果 各組血澱粉酶均明顯升高,但組間比較差異無統計學意義(P＞0.05).營養8 d後EIN組外週血內毒素為(1.50±0.18)EU/L,腸道通透性為(42.8±20.0)×10-3,明顯低于EEN組[(1.98±0.20)EU/L,(67.4±23.0)×10-3]和PN組[(3.96±0.40)EU/L,(197.2±47.4)×10-3](P值均＜0.05).EIN組胰腺和遠隔髒器細菌數及細菌移位率亦明顯低于PN組和EEN組(P＜0.05);三組間胰腺病理評分差異無統計學意義(P＞0.05).EIN組小腸絨毛高度、隱窩深度、黏膜厚度和絨毛形態正常率分彆為(398.27±52.93)μm、(269.72±41.66)μm、(681.98±58.33)μm和79%,EEN組分彆為(305.70±42.72)μm、(1 92.52±38.17)μm、(507.31±68.23)μm和47%,PN組分彆為(218.32±35.81)μm、(145.76±23.34)μm、(376.20±48.23)μm和13V0,EIN組以上指標值均高于EEN組和PN組(P值均＜0.05).結論 EIN能保護SAP豬腸道屏障功能,降低腸道通透性,減少細菌及內毒素移位.
목적 관찰장내면역미생태영양(EIN)대중증급성이선염(SAP)모형저장도병장공능적영향.방법 가양저20두주입5%우광담산납화이단백매건립SAP모형.24 h후장18두성공조모저균분위장외영양(PN)조、장내요소영양(EEN)조화EIN조,분별진행상응영양지지8 d.분별우조모전、후각시간점검측각조혈정분매、외주혈내독소급장도통투성.8 d후처사동물취외주정맥혈、이、비、간、폐화장계막림파결진행세균정성급정량검측,동시관찰회장말단점막형태급이선조직병이학개변병작병리평분.결과 각조혈정분매균명현승고,단조간비교차이무통계학의의(P＞0.05).영양8 d후EIN조외주혈내독소위(1.50±0.18)EU/L,장도통투성위(42.8±20.0)×10-3,명현저우EEN조[(1.98±0.20)EU/L,(67.4±23.0)×10-3]화PN조[(3.96±0.40)EU/L,(197.2±47.4)×10-3](P치균＜0.05).EIN조이선화원격장기세균수급세균이위솔역명현저우PN조화EEN조(P＜0.05);삼조간이선병리평분차이무통계학의의(P＞0.05).EIN조소장융모고도、은와심도、점막후도화융모형태정상솔분별위(398.27±52.93)μm、(269.72±41.66)μm、(681.98±58.33)μm화79%,EEN조분별위(305.70±42.72)μm、(1 92.52±38.17)μm、(507.31±68.23)μm화47%,PN조분별위(218.32±35.81)μm、(145.76±23.34)μm、(376.20±48.23)μm화13V0,EIN조이상지표치균고우EEN조화PN조(P치균＜0.05).결론 EIN능보호SAP저장도병장공능,강저장도통투성,감소세균급내독소이위.
Objective To evaluate the effect of ecoimmunonutrition on maintenance of the mucosal barrier function in pigs with severe acute pancreatitis(SAP).Methods Twenty pigs were injected with5% sodium taurocholate and trypsin into the pancreatic duct to establish SAP models.Twenty four hours later,18 suvival pigs were randomly given parenteral nutrition(PN group,n=6),elemental enteral nutrition(EEN group,n=6),or ecoimmunonutrition(EIN group,n=6)for 8 days.The serum amylase,endotoxin and intestinal permeability were determined on different times.All pigs were sacrificed 8days later,and their venous blood,mesenteric lymph nodes(MLN),liver,lung,spleen and pancreas specimens were cultured quantitatively and qualitatively with standard techniques.The morphology of small bowel was observed and pathological changes of the pancreas was analyzed.Results Serum amylase of all groups were obviously elevated,but there was no significant difference among them(P＞0.05).The plasma endotoxin and intestinal permeability were lower in EIN group[(1.50±0.18)EU/L and(42.8±20.0)×10-3 respeetively]compared to EEN group[(1.98 4±0.20)EU/L and(67.4±23.0)×10-3 respectively]and PN group[(3.96±0.40)EU/L and(197.2±47.4)×10-3.respectively](all P value＜0.05).The incidence and the magnitude of bacterial translocation in EIN group were lower than those in PN and EEN groups.However,the ileum mucosa thickness,villus height,crypt depth and the rate of the normal intestinal villi in EIN group were(398.27±52.93)μm,(269.72±41.66)μm,(681.98±58.33)μm and 79%,respectively,but in PN group were(218.32±35.81)μm,(145.76±23.34)μm,(376.20±48.23)μm and13%,respectively and in EEN group were(305.70±42.72)μm,(192.52±38.17)μm,(507.31±68.23)μm and 47%,respectively.Conclusions EIN can maintain the integrity of intestinal mucosal barrier and decreasing intestinal bacterial and endotoxin translocation in SAP pigs.
