表皮生长因子、谷氨酰胺强化的全胃肠外营养对肠屏障功能和肠细菌移位的影响

Effect of Epidermal Growth Factor and Glutamine Supplemented Toal Parenteral Nutrition on Gut Barrier and Bacterial Translocation

目的 探讨表皮生长因子 (epidermalgrowthfactor,EGF)、谷氨酰胺 (glutamine ,GLN)对全胃肠外营养(totalparenteralnutrition ,TPN)并发症的防治作用及机制。方法 将大白鼠分为 4组 :A(正常喂养组 )、B(标准胃肠外营养STPN)、C(TPN +GLN)、D(TPN +EGF +GLN) ,采用大白鼠TPN模型 ,一周后取大鼠近端空肠组织切片行光镜和电镜观察 ,结合图像分析 ;无菌采取肠系膜淋巴结 (mesenterlymphonodus,MLN)并称重和抽取腹腔静脉血作细菌培养 (需氧培养 )。结果 B组肠黏膜萎缩 ,MLN细菌培养阳性率 6 2 .5 %。C组较B组肠黏膜萎缩减轻 ,黏膜DNA、RNA含量和浆细胞数目增加 ,MLN细菌培养阳性率 37.5 % ,肠细菌移位率下降。而D组上述各指数与正常鼠A组无显著差异。 4组动物血培养均为阴性。

Purpose To detect the prevention of EGF and GLN on the side effect of TPN. Methods We randomized SD rats into four groups:group A (control),B(STPN),C(TPN+GLN),D(TPN+GLN+EGF).All rats were maintained on their respective diets for 8 days,at which time they were killed and the proximal jejunum was incised for biopsy,the MLN and celiac vein blood were collected for bacterial culture(aerobic culture). Results Group B rat mucosal cell atrophied,DNA and RNA content and plasma cell decreased,the positive rat of MLN bacterial culture was 62.5%.Atrophy in group C alleviated and bacterial translocation rate declined(37.5%).Group D was similar with group A. Conclusions GLN combined with EGF is more effective in protecting gut barrier function and preventing bacterial translocation than GLN alone.