不同营养治疗途径对重症急性胰腺炎大鼠血浆氨基酸谱和电解质的影响

Influence of Different Nutritional Supports on Plasm Amino Acids and Electrolytes in Severe Acute Pancreatitis Rat

目的比较不同配方肠内营养(EN)和肠外营养(PN)制剂对重症急性胰腺炎(SAP)大鼠血浆氨基酸谱和电解质水平的影响。方法建立大鼠SAP模型,根据SAP营养代谢配制专用EN配方(EN-S)和含益生元(PRE)的EN配方(RPE-EN)。40只大鼠随机分为正常对照组(A组)、SAP+EN-S组(B组)、SAP+PRE-EN组(C组)、SAP+商品EN组(D组)和SAP+PN组(E组),营养治疗持续7 d,检测血浆氨基酸谱和电解质水平。结果B^E组主要氨基酸和总氨基酸水平显著低于A组(P<0.05),D组天门冬氨酸、蛋氨酸和赖氨酸水平显著低于B组(P<0.05)和C组,而谷氨酸、精氨酸、丙氨酸和苯丙氨酸显著低于C组(P<0.05),低于B组但无显著性差异;B^E组血清铁显著低于A组(P<0.05),D组的血清铁显著低于C组(P<0.05),除C组外,其余各组的血浆钠显著低于A组。结论EN-S配方在提高某些氨基酸水平上作用优于商品EN;含PRE微生态营养制剂具有改善蛋白质代谢和电解质平衡的作用;短期应用EN和PN对SAP动物蛋白质代谢和电解质平衡作用无显著性差异。

To study the influence of specific EN formula （ EN - S）, EN - S formula with prebiotics （ PRE）, commercial EN formula and PN on plasm amino acids and electrolytes in SAP rats, SAP specific formula （ EN - S） was prepared based on the nutritional and metabolic characteristics of SAP, and the micro - ecological EN formula was prepared with EN - S plus prebiotics. Forty SD rats were divided randomly into 5 groups： normal control （group A） ,SAP with EN -S （group B ）, SAP with PRE -EN （group C ）, SAP with commercial EN （group D）, and SAP with PN （group E）. The nutritional therapy lasted for 7d. Blood samples were collected ,and plasm amino acids and electrolytes were analyzed. The level of main free amino acids and total free amino acids in group B - E was significantly lower than group A （ P 〈 0.05 ）, and the level of Asp, Met and Lys in group D was significantly lower than group C （ P 〈 0.05 ）, lower than group B but without significance. The level of Fe^2＋ in group B - E was significantly lower than group A （ P 〈 0.05 ） , and the level in group D was significantly lower than group C （ P 〈 0. 05 ）. Besides group C, the level of Na ＋ in other groups was significantly lower than group A （ P 〈 0.05 ） It was suggested that EN - S was better in increasing the level of certain amino acids than commercial EN. The effect of PRE - EN in improving protein metabolism and electrolyte balance was superior to other formulas. The difference was not significant between the effect EN and PN for short usage on protein metabolism and electrolyte balance.