摘要
目的观察不同营养支持途径给予谷氨酰胺(G ln)对严重烧伤所致肠黏膜屏障功能损害的影响并探讨其机制。方法采用30%总体表面积Ⅲ度烧伤大鼠模型,160只W istar大鼠按随机数字表法分成正常对照(C)组、烧伤对照(B)组、G ln静脉营养组〔采用肠外营养(PN)+G ln〕和G ln肠道营养组〔采用肠内营养(EN)+G ln〕。各组烧伤大鼠采用等氮、等热量的营养支持,EN+G ln组给予1.0 g.kg-1.-d 1G ln;PN+G ln组给予等量谷氨酰胺双肽;B组使用等量酪氨酸。观察烧伤后1、3、5、7和10 d肠黏膜屏障功能的变化及不同营养支持途径给予G ln对其的影响。结果烧伤后肠黏膜损伤指数、通透性及血浆二胺氧化酶(DAO)活性均明显高于C组(P均<0.01),而肠黏膜血流量、肠黏膜厚度、绒毛高度、隐窝深度及肠上皮细胞增殖指数则明显降低(P<0.05或P<0.01)。与B组比较,PN+G ln组和EN+G ln组对上述指标的改变均有一定的逆转作用,与PN+G ln组比较,EN+G ln组的疗效更优。结论经肠道补充G ln更有利于减轻烧伤后肠黏膜受损程度,促进肠黏膜修复。
Objective To observe the effect of glutamine given through different avenues on intestine mucosal barrier damage induced by severe burn injury. Methods One hundred and sixty Wistar rats were randomly divided into four groups ： namely normal control （C group）, burned control （B group）, parenteral nutrition with glutamine （PN＋GLN group） and enteral nutrition with glutamine （EN＋GLN group）. Rats in B group, PN＋GLN group, and EN＋GLN group were subjected to 30% total body surface area （TBSA） full-thickness burn injury. In the latter three groups, nutritional intake was isonitrogenous and isocaloric. In PN-t-GLN group and EN＋GLN group the nutrition were supplemented with glutamine 1.0g·kg^-1·d^-1, and in B group tyroslne 1.0 g·kg^-1·d^-1. Indexes relevant to injury to the intestine were determined on postburn day （PBD） 1, 3, 5, 7 and 10. Results After burn injury, the index of intestinal mucosal injury, intestine mucosal permeability and the activity of plasma diamine oxidase （DAO） were significant increased compared with C group （all P〈0. 01）. On the other hand, the intestine mucosal blood flow （IMBF）, mucosa thickness, villous height, crypt depth and intestinal epithelial proliferation index were significantly decreased （P〈0. 05 or P〈0.01）. Compared with B group, the extent of changes in these indices were lowered in PN＋GLN group and EN＋GLN group （P（0.05 or P（0.01）, and the effects were more marked in EN＋GLN group than those in PN＋GLN group. Conclusion GLN is beneficial in minimizing intestinalinjury, promoting intestinal mucosal repair. Enteral supplementation of GLN is a better way of administration.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2006年第10期619-622,共4页
Chinese Critical Care Medicine
关键词
肠道营养
静脉营养
谷氨酰胺
肠黏膜屏障功能
烧伤
enteral nutrition
parenteral nutrition
glutamine
intestinal mucosal barrier function
burn
