摘要
目的通过比较烧伤患者早期肠内喂养含MCT/LCT与只含LCT的肠内营养制剂对烧伤后肠道缺血再灌注损伤的不同影响,探讨MCT/LCT减轻烧伤后肠道缺血再灌注损伤的作用及可能机制。方法选取30例烧伤总面积(TBSA)>30%的烧伤患者,并随机分为2组:Fresubin750MCT组(F组),即饲以含MCT/LCT的肠内营养制剂Fresubin750MCT;Nutrison组(N组),即饲以只含LCT的肠内营养制剂Nutrison。于伤后24h内进行完全肠内营养支持,共支持10d。在烧伤后1、4、7、10d分别观察两组患者肠道损伤的情况(包括血浆SOD、MDA、尿L/M及血清DAO水平)。结果烧伤后肠道缺血及再灌注损伤明显,肠道通透性增加。F组患者血浆SOD明显升高,DAO、MDA及尿L/M值明显下降。结论含MCT/LCT的肠内营养制剂较只含LCT者,在减轻烧伤后肠道缺血及再灌注损伤、促进肠粘膜细胞增殖修复、降低肠道通透性等方面有更佳的疗效,能更有效地保护烧伤后肠道的屏障功能。
Objective To compare the effects of different fat nutrients(MCT/LCT vs.LCT only)on the protection of intestinal mucosa from ischemical reperfusion injury in burned patients.Methods A prospective,randomized,single blind and controlled trial was conducted involving thirty cases of burned patients with the total burn surface area(TBSA)more than30%.The patients were randomized into two groups.(1)Group F:enteral feeding with Fresubin750MCT containing MCT as one of the fat source s,(2)Group N:enteral feeding with Nutrison,which contained only LCT as fat source.All of the thirty patients received isocaloric,isonitrogenous,and isolipidic enteral feeding,with intragastric tube and enteral feeding pump,started within24h postburn.The following parameters were observed on postburn day(PBD)1,4,7and10:the plasma concentrations of superoxide dismutase(SOD)and malondialdehyde(MDA),the serum diamine oxidase(DAO)activity,and the permeability of intestinal mucosa.Results The results showed that group F had a increased concentration of plasma SOD and MDA,an increased serum DAO activity,and a decreased lactulose/mannitol ratio in urine compared with group N.Conclusions The compound diet containing MCT/LCT is better than LCT only in protecting the intestinal mucosa from ischemical reperfusion injury in burned patients.
出处
《中国临床营养杂志》
2002年第3期160-164,共5页
Chinese Journal of Clinical Nutrition
关键词
肠内营养
烧伤
肠道缺血
再灌注损伤
临床研究
中链脂肪
early enteral nutrition
burn
medium-chain triglyceride
intestinal mucosa
ischemical reperfusion injury
