摘要
背景:重症急性胰腺炎(SAP)患者存在不同程度的免疫功能抑制,与疾病的发展和转归密切相关。研究显示肠内营养(EN)尤其是生态免疫营养(EIN)应用于SAP较肠外营养(PN)有显著优越性。目的:探讨肠内EIN对猪SAP模型免疫功能的影响。方法:制备猪SAP模型,18只实验猪随机分为PN组、肠内要素营养(EEN)组和EIN组,分别予营养支持8d。动态检测各组血清、胰淀粉酶水平、T细胞亚群和血清IgG、IgA、IgM水平,观察胰腺组织病理学改变。结果:造模后各组血清、胰淀粉酶水平明显升高,CD3+、CD4+T细胞和CD4+/CD8+比值降低,血清IgG、IgA、IgM水平降低,予营养支持后上述指标均有所改善(除PN组血清IgG水平)。除血清淀粉酶和IgM水平,EIN对其余各指标的改善作用均较PN和EEN更为明显(P<0.05)。三组间胰腺组织病理学评分无明显差异。结论:早期肠内EIN增强猪SAP模型免疫功能的作用优于PN和EEN,可明显提高治疗效果。
Background： Inhibition of immune function in severe acute pancreatitis （SAP） has close correlation with the progress and prognosis of the disease. It has been reported that enteral nutrition （EN）, especially ecoimmunonutrition （EIN） is superior to parenteral nutrition （PN） in the treatment of SAP. Aims： To investigate the effect of enteral EIN on the immune function of SAP in pig model. Methods： Eighteen pigs were randomly divided into three groups, PN group, elemental enteral nutrition （EEN） group, and EIN group after induction of SAP. Each group was treated with abovementioned nutrition supports for eight days, respectively. The serum and pancreatic amylase, T lymphocyte subsets, and serum IgG, IgA and IgM levels were determined dynamically, and the histopathological changes of pancreas were examined. Results： Serum and pancreatic amylase increased, and CD3^＋, CD4^＋ T lymphocytes and CD4^＋/CD8^＋ ratio, as well as serum IgG, IgA and IgM levels decreased after SAP induction. When treated with nutrition supports, most of the indices mentioned above improved. The effect of EIN was better than that of PN and EEN （P〈0.05） except for serum amylase and IgM levels. The histopathological score of pancreas was not significantly different between these three groups. Conclusions： Early enteral EIN is superior to PN and EEN in enhancing immune function of SAP in pig model, which may improve the treatment efficacy.
出处
《胃肠病学》
2008年第5期285-289,共5页
Chinese Journal of Gastroenterology
关键词
重症急性胰腺炎
生态免疫营养
肠道营养
胃肠外营养
免疫
Severe Acute Pancreatitis
Ecoimmunonutrition, Enteral Nutrition
Parenteral Nutrition
Immunity
