早期肠内营养对重症急性胰腺炎大鼠炎性反应的影响

THE EFFECT OF EARLY ENTERAL NUTRITION ON THE ACUTE INFLAMMATORY REACTION IN SEVERE ACUTE PANCREATITIS IN RATS

目的 研究早期肠内营养 (EEN )和完全肠外营养 (TPN)对重症急性胰腺炎 (SAP)大鼠急性期炎性反应的影响 ,探讨早期 EEN对 SAP的治疗作用。方法 6 0只 1 80～ 2 2 0 g雄性 SD大鼠随机分为 EEN组、TPN组及假手术 (S)组 ,成模后分别行 TPN过渡至 EEN、TPN及正常喂养。检测 2周后实验动物死亡率、胰腺病理学和血清淀粉酶、CRP、IL - 1β、IL - 6及TNF-α的水平。结果 1 . EEN和 TPN组间动物死亡率、血清淀粉酶水平差异无显著性 (p>0 .0 5 ) ,胰腺病理改变类型及程度相似 ;2 . EEN组血清 CRP及 IL - 6水平显著低于 TPN组 (p<0 .0 5 ) ,而两组间 TNF-α及 IL - 1β水平差异无显著性 (p >0 .0 5 )。结论 早期 EEN并不会加重 SAP大鼠急性期胰腺组织和系统的炎性反应 。

Objective To study the influence of early enteral nutrition (EEN) and total parenteral nutrition (TPN) on the acute inflammatory reactions in severe acute pancreatitis (SAP), and evaluate the effect of early EEN support on SAP in rats.Methods Sixty male SD rats were randomly assigned into EEN group, TPN group and sham operated (S) group. SAP model was set up for EEN and TPN groups. Transitional enteral nutrition, TPN or normal chew was given for 2 weeks to the three groups, respectively. The death rates and pathological changes of pancreas were observed, and the serum levels of amylase, CRP, IL 1β, IL 6 and TNF α were also detected.Result 1. No significant differences showed between the death rate or serum amylase level of EEN group and that of TPN group (p<0.05, either). The pathological changes of pancreas of the two groups were similar. 2. The serum levels of CRP and IL 6 were significantly lower in EEN group than those in TPN group (p<0.05, both), but no significant difference showed between the serum levels of TNF αor IL 1β of the two groups (p<0.05, either).Conclusion EEN support does not increase the acute inflammatory reactions in pancreas or systemically, but can effectively decrease the infection rate and the severity of infectious inflammation in SAP rats.