富含精氨酸早期肠内营养对烧伤后肠黏膜增殖的实验研究

An experimental study of the effects of early enteral feeding of Larginine enriched food on postburn intesti-nal mucosal proliferation in rats

目的 研究富含精氨酸的肠内营养对大鼠烧伤后肠道黏膜上皮增殖的影响。方法 观察富含精氨酸早期肠内营养组（ＡＥＦ组）、单纯早期肠内营养组（ＥＦ组）及延迟肠内营养（ＤＦ组）大鼠在烧伤后第 １、３、６和９ ｄ时，肠黏膜增殖细胞核抗原标记指数（ＰＣＮＡＬＩ）和肠黏膜脱氧核糖核酸（ＤＮＡ）的变化。结果 在烧伤后第１天，各组肠道黏膜ＰＣＮＡ的阳性细胞极为罕见。与ＤＦ组相比，在烧伤后第３天ＡＥＦ组肠黏膜ＰＣＮＡＬＩ即有明显升高［（２０．６１±７．５３）‰ ｖｓ（６．９±２．７）‰，Ｐ＜０．０５），而ＥＦ组在烧伤后第６天才有显著升高（１８．２±５．１）‰ｖｓ（１０．８１±５．１０）‰Ｐ＜０．０５］。结论 烧伤后肠黏膜屏障受损，肠上皮细胞增殖受抑。单纯早期肠道可减轻肠黏膜损害，但不能尽快改善肠道黏膜增殖。通过在早期肠道营养中加用精氨酸可进一步增加肠道黏膜上皮的增殖。

Objective To investigate the effects of early enteral feeding of L - arginine enriched food on postburn intestinal mucosal proliferation in rats. Methods Twenty Wistar rats prepared with gastrosto- my 7 days before the experiment were inflicted by 30% TBSA flame burn, and were divided into early enteral feeding(EF) , L - arginine enriched early enleral feeding group( AEF) receiving feeding from 2 PBHs and delayed feeding (DF) group, receiving feeding from 48 PBHs. The changes in intestinal mucosal DNA con- tent and intestinal mucosal proliferating cell nuclear antigen labeling index (PCNALI) were determined on the 1st,3rd,6th and 9th postburn days (PBDs) respectively in rats. Results There were rare intestinal mucosal PCNA positive cells on the 1st PBD in all groups. Compared with that in DF group,the intesinal mu- cosal PCNALI in AEF group increased obviously on 3 PBD,while that in EF group increased evidently on 6 PBD. ( P <0.05) Conclusion There existed intestinal mucosal injury postburn as shown by the inhibition of intestinal epithelial proliferation. Early enteral feeding with L - arginine enriched food could not only amel- iorate intestinal mucosal injury,but also enhance the proliferation of intestinal mucosal epithelium.