摘要
目的探讨精氨酸、谷氨酰胺双肽强化肠外营养(PN)对创伤后肠屏障功能和机体免疫功能的影响。方法将50只雄性Wister大鼠创伤后随机分为对照组、传统PN组(PN)、精氨酸强化PN组(PNA)、谷氨酰胺双肽强化PN组(PNG)和精氨酸谷氨酰胺双肽强化PN组(PNAG)5组,每组10只。经7天营养支持后分别检测体重、空肠黏膜厚度、绒毛高度、结肠黏膜厚度、肠系膜淋巴结细菌移位率、周围血淋巴细胞增殖能力。结果(1)手术前5组大鼠的平均体重差异无显著性,术后7天接受PN支持的4组大鼠体重均较术前降低,而对照组则有增加,其中PN组和PNA组较含有谷氨酰胺强化的两组体重降低更为显著(P<0.05)。(2)经过7天PN支持后,PN组和PNA组空肠和结肠的黏膜厚度及空肠绒毛高度较对照组明显降低(P<0.05);PNG组和PNAG组则与对照组相似。(3)术后第8天,各组细菌移位阳性率以PN组最高,PNA组次之,PNG组和PNAG组与对照组间差异无显著性。(4)治疗前各组大鼠周围血淋巴细胞在有丝分裂原ConA和PHA刺激后增殖率相似;经7天营养支持后,接受PN支持的PN组和PNA组大鼠淋巴细胞增殖率明显低于对照组(P<0.05),而PNG组和PNAG组与对照组比较差异无显著性(P>0.05),除对照组外各组均有减低,但仅在PN组和PNA组较术前有明显下降(P<0.05)。结论PN液中添加谷氨酰胺对创伤后减轻肠黏膜萎缩、维护肠屏障功能、减少肠道细菌移位以及维护机体细胞免疫功能有积极作用,而精氨酸并未显示出这些作用。
Objective To evaluate the effect of alanyl-glutamine and/or arginine-enriched parenteral nutrition （PN） on immune function and gut-barrier function of postwound rats. Methods Fifty wounded male Wister rats were divided into 5 groups： control group, receiving normal diet; PN group, receiving conventional PN; PN-A group, receiving arginine-enriched PN; PN-G group, receiving alanyl-glutamine-enriched PN; PN-A-G group, receiving alanyl-glutamine and arginine-enriched PN. The rats received PN from the 1^st postwound day to the 7^th postwound day. PN in each group was isonitrogenic and isocarloric. The morphology of the intestinal mucous and proliferation of the peripheral lymphocytes were observed. Results The weights of rats in all PN groups were lower at the 7^th postwound day than before operation; the weights of rats in PN and PN-A groups were significantly lower than those in PN-G and PN-A-G group （ P 〈 0.05 ）. After 7 days of PN supports, the mucosa thickness of jejunum and colon and the villi heights of jejunum were significantly decreased in PN group and PN-A group than in control group; however, those in PN-G group and PN-A-G group were similar to in control group. The bacterial translocation rates in .PN group and PN-A group were significantly higher than in PN-G group, PN-A-G group, and control group. The proliferation rates of the peripheral lymphocyte in both two glutamine （GLN） -enriched nutrition groups were similar to that in the control group ; after 7 days of treatment, the proliferation rates of the peripheral lymphocytes were significantly lower in PN group and PN-A group than in control group （ P 〈 0.05 ）, while no such difference was observed between PN-G/PN-A-G group and control group （ P 〉 0.05 ）. The proliferation rates of the peripheral lymphocytes were significantly decreased after operation in the PN group and PN-A group. Conclusion GLN-enriched PN can eliminate the atrophy of gut mucous, bacterial translocation, and immunosuppression following major wounds, but arginine lacks such effects.
出处
《中国临床营养杂志》
2006年第2期95-99,共5页
Chinese Journal of Clinical Nutrition
