摘要
目的:研究单独或联合应用谷氨酰胺(Gln)和重组人生长激素(rhGH)对门脉高压症术后肠粘膜屏障功能的保护作用及机制。方法:29例门静脉高压症术后患者随机分为4组:①Gln组(n=6),②rhGH组(n=8),③Gln+rhGH组(n=7)和④对照组(n=8)。术后3d开始进行等氮、等热量的全胃肠外营养支持(TPN),持续7d。对手术前、后的尿乳果糖排泄率/甘露醇排泄率(L/M)、十二指肠粘膜绒毛高度、陷窝深度及肠粘膜增殖细胞核抗原(PCNA)表达指数进行对比。结果:Gln+rhGH组术后L/M值升高小于对照组(P<0.05),肠粘膜绒毛高度和陷窝深度大于对照组(P<0.05)及术前(P<0.05),肠粘膜上皮PCNA表达指数大于术前及其它3组(P<0.05);对照组术后绒毛高度小于术前(P<0.05),陷窝深度变化无显著(P>0.05)。结论:联合应用Gln和rhGH能降低门脉高压症术后肠壁通透性并维护肠粘膜形态学完整性,单用Gln或rhGH无此作用。这种作用可能与增加肠黏膜PCNA表达而促进肠黏膜上皮细胞增殖有关。
AIM： To investigate morphologic and functional changes of small intestinal mucosa and proliferating cell nuclear antigen in postoperative portal hypertension patients with single or combined administration of Gln and rhGH. METHODS ： Twenty - nine portal hypertension patients with surgical treatment were prospectively randomized to four groups as follows ： ① Gln group （ n = 6 ） ; ② rhGH group （ n = 8 ） ; ③ Gln ＋ rhGH group （ n = 7 ） and ④ control group （ n = 8 ）. A standard solution for TPN was given three days after operation for a week. The concentration ratio of urinary lactulose and mannitol （L/M） , the villus height and crypt depth and PCNA index of small intestinal mucosa were compared. RESULTS： A week after TPN postoperation, the increased ratios of L/M in Gln ＋ rhGH group were less than those in control group （P 〈 0. 05）. The villus height and crypt depth increased in Gln ＋ rhGH group compared with preoperation （P 〈0. 05） or control group （P 〈 0. 05 ）. PCNA index increased in Gln ＋ rhGH group compared with preoperation （ P 〈 0.05 ） or other three groups （ P 〈 0. 05 ）. The villus height of control group decreased （ P 〈 0. 05 ） , whereas the crypt depth had no significant difference （P 〉 0. 05）. CONCLUSION： This study suggest that Gln together with rhGH reduce the intestinal permeability and protect the mucosa integrality in postoperative portal hypertension patients, but not in single treatment.
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2006年第9期1825-1828,共4页
Chinese Journal of Pathophysiology
关键词
谷氨酰胺
生长激素
门静脉高压症
肠粘膜屏障
增殖细胞核抗原
Glutamine
Growth hormone
Portal hypertension
Intestinal mucosa barrier
Proliferating cell nuclear antigen
