不同肠内营养液与生长激素联合应用对烫伤大鼠炎性反应的影响

Effects of different enteral nutrition formulae combined with recombinant human growth hormone on inflammatory response in rats with scald injury

目的了解标准肠内营养（EN）、肠内免疫营养（EIN）液与重组人生长激素（rhGH）联合应用对烫伤大鼠炎性反应的影响。方法将128只SD大鼠按随机数字表法分为EN、EIN、EN＋rhGH、EIN＋rhGH组，每组32只。将大鼠制成总面积30％TBSA的m度烫伤模型，分别于伤后1、4、7、10d抽取各组大鼠静脉血，检测血清内毒素、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）水平；切取大鼠肝组织检测其CD14 mRNA、TNF-α mRNA的表达。另取8只SD大鼠作为对照组，检测上述指标。结果伤后各组各时相点大鼠血清内毒素、IL-6、TNF-α水平以及肝组织中的CD14 mRNA、TNF-α mRNA表达均高于对照组（P〈0．01）。伤后4、7、10d，EIN组和EN＋rhGH组血清内毒素、IL-6、TNF-α水平以及肝组织CD14 mRNA、TNF-α mRNA表达均低于EN组（P〈0．05或P〈0．01）；伤后10d，EIN＋rhGH组血清内毒素[（0．37±0．07）EU／mL]、IL-6[（289-49）ng／L]、TNF-α[（1．87±0．32）μg／L]水平以及肝组织CD14mRNA（0．39±0．05）、TNF-α mRNA（0．47±0．03）表达均低于EIN组[（0．48±0．08）EU／mL、（364±53）ng／L、（2.50±0．48）μg／L、0．67±O．06、0．66±0．05，P〈0．05或P〈0．01]。结论EN、EIN液与rhGH联合应用可减轻大鼠烫伤后的炎性反应，且rhGH具有明显的协同作用。

Objective To investigate the effects of enteral immunonutrition or enteral nutrition com- bined with recombinant human growth hormone（rhGH） on inflammatory response in rats with severe scald. Methods One hundred and twenty-eight SD rats were inflicted with 30% TBSA full-thickness scald, then they were divided into enteral nutrition （EN） , enteral immunonutrition（ EIN ） , EN combined with rhGH （EN ＋ rhGH） and EIN combined with rhGH （EIN ＋ rhGH） groups according to random number table. The serum levels of endotoxin, IL-6 and TNF-α as well as the expression of CD14 and TNF-α mRNA in liver were determined on the 1,4,7,10 post scald day（PSD）. Eight normal SD rats served as control, and above indices were also examined in this group （ C group）. Results The levels of endotoxin, IL-6 and TNF-α as well as the expression of CD14mRNA,TNF-αmRNA in EN, EIN, EN ＋ rhGH, EIN ＋ rhGH groups were remarkably higher than those of C group at each time point. The levels of endotoxin,IL-6 and TNF-α as well as the expression of CD14 mRNA ,TNF-α mRNA in EIN and EN ＋ rhGH groups were lowered significantly on 4,7 and 10 PSD compared with those of EN group （ P 〈 0.05 or P 〈 0.01 ）. The levels of endotoxin（0.37 ± 0. 07 EU/mL） ,IL-6（289 ±49 ng/L） and TNF-α（ 1.87 ±0.32 ixg/L） as well as the expression of CD14 mRNA （0.39 ± 0.05）, TNF-α mRNA （0.47±0.03 ） in EIN ＋ rhGH group were also obviously lower than those E （0.48 ±0.08） EU/mL,（364±53）ng/L,（2.50 ±0.48） μg/L,0.67±0.06,0.66±0.05, P 〈0.05 orP 〈0.01,respectively]in EIN group on 10 PSD（ P 〈0.05 orP 〈0.01）. Conclusion Enteral immunonutrition combined with rhGH can ameliorate inflammatory response,in which rhGH has a collaborative effect.