胰岛素对短肠综合征大鼠蛋白质代谢及肠功能代偿的影响

Effect of insulin on protein metabolism and intestinal adaptation in enteral nutrition in a rat model of short bowel syndrome

目的：采用短肠综合征（SBS）大鼠的TEN模型，研究胰岛素（INS）对蛋白质代谢的影响及其残存肠管的代偿作用。方法：将30只大鼠随机分为三组，每组10只。假手术（Sham）组、短肠（SBS）组和短肠＋胰岛素（SBS-INS）组。Sham组大鼠仅切断吻合小肠；SBS组切除85％小肠；SBS．INS组切除85％以上小肠并皮内注射速效胰岛素制剂。各组大鼠术后均行TEN支持。观察大鼠术后的一般情况、营养状况、氮平衡、残存肠黏膜DNA和蛋白质含量、肠绒毛高度、肠隐窝深度和隐窝细胞的增殖指数。结果：SBS．INS组大鼠术后第12-14天体质量显著高于SBS组，术后第5～14天，氮平衡亦显著优于SBS组；SBS-INS组大鼠的营养指标、肠黏膜DNA和蛋白质含量、肠绒毛高度、肠隐窝深度和隐窝细胞的增殖指数，显著高于SBS组。结论：胰岛素能促进EN支持的SBS大鼠蛋白质合成及残存肠管的代偿，从而增加肠道的吸收面积，改善营养状况。

Objective ： The purpose of the present study was to investigate the effects of insulin on protein metabo-lism and intestinal adaptation in a rat model of short bowel syndrome （SBS） with total enteral nutrition （TEN）. Methods： Thirty, male SD rats were assigned into three experimental groups, each of 10： Sham rats （Sham group） underwent bowel transection and reanastomosis, SBS rats （SBS group） underwent a 85% small bowel resection, and SBS-INS rats （SBS-INS group） underwent a 85% small bowel resection as above and were treated with insulin subcutaneously during days 3-14 postoperatively. All rats received identical TEN solutions. Body weight, nitrogen balance, nutritional index, intestinal mucosal DNA and protein, villus height, crypt depth and crypt cell proliferative index were determined. Results： Body weight increase in SBS-INS group was significantly more than that in SBS group from day 12 to 14. SBS-INS rats demonstrated positive nitrogen balance from day 5 to14. Nutritional in-dex, intestinal mucosal DNA and protein content, intestinal villus height, crypt depth, and crypt cells proliferative index in SBS-INS group were higher than those in SBS group. Conclusion： Insulin promotes protein metabolism and intestinal adaptation in a rat model of SBS.