谷氨酰胺强化的肠内营养减轻大鼠烧伤后肠道损伤的实验研究

Glutamine-enriched enteral nutrition relieves rat burn-induced intestinal mucosal lesions

目的观察谷氨酰胺对严重烧伤所致肠黏膜损害的影响。方法采用30%体表面积Ⅲ度烧伤大鼠模型,随机分成烧伤组(B组)和谷氨酰胺组(G组),两组给予等氮、等热卡、等体积的营养液。G组每天给予30%总氮量的谷氨酰胺,对照组给予等量的甘氨酸。观察烧伤前及烧伤后第1、2、3、4、5、6、7天大鼠的氮平衡变化,同时检测烧伤后血浆D-乳酸、二胺氧化酶(DAO)活性及肿瘤坏死因子(TNF)、内毒素(LPS)的含量。结果烧伤后两组大鼠的氮平衡、D-乳酸、DAO、TNF及LPS均显著高于烧伤前,差异有统计学意义(P<0.01);G组的氮平衡明显高于B组,而血浆D-乳酸、DAO活性及TNF、LPS含量均明显低于B组,差异有统计学意义(P<0.05,P<0.01)。结论添加谷氨酰胺的肠内营养可以减轻烧伤后肠道损伤,降低血浆炎症介质水平。

Objective To explore the effect of glutamine on intestine damage after severe burn injury. Methods Ninety Wistar rats were inflicted with 30% total body surface area full thickness burns and then randomly divided into burned control （B） group and glutamine treatment （G） group. Isonitrogenous and isoealoric nutrition supports were provided to both two groups. Rats in G group and B group were administered with glutamine or glycine at the rate of 30 % total nitrogen respectively. Nitrogen balance,D- lactate,DAO,and the levels of plasma TNF,LPS were determined. Results After burn injury,the nitrogen balance,D-laetate,DAO activity,and levels of TNF, LPS significantly increased. Compared with B group, nitrogen balance was significantly higher, while plasma D-lactate,DAO activity and levels of TNF,LPS were significantly lower. Conclusion Oral glutamine administration may relieve intestine damage after severe burn injury and lower the level of plasma inflammatory cytokines.