肠道营养减轻严重烧伤所致肠道损害的实验研究

Experimental study of enteral nutrition minimizing intestine damage induced by severe burns

目的 观察肠道营养对严重烧伤所致肠粘膜损害的影响并探讨其机制。方法 采用 30 %体表面积Ⅲ度烧伤大鼠模型 ,随机分成伤前对照 (C) ,静脉营养 (PN)及肠道营养 (EN)组 ,EN和PN组给予等氮、等热卡、等体积的营养液。在此基础上动态观察了肠粘液层厚度、肠上皮细胞增殖指数、血浆内毒素含量及血浆二胺氧化酶 (DAO)活性。结果 烧伤后肠粘膜组织结构受损 ,血浆内毒素水平及DAO活性明显高于伤前 ,而肠上皮细胞增殖指数和肠粘液层厚度则明显低于伤前。同PN组相比 ,EN组大鼠肠道受损程度、血浆内毒素水平及DAO活性明显降低 ,而肠上皮细胞增殖指数和肠粘液层厚度则明显增高。结论 严重烧伤后肠粘膜屏障功能受损 ,肠上皮细胞增殖能力下降。与静脉营养相比 ,肠道营养可减轻肠粘膜受损程度 。

Objective To explore the mechanism and effects of enteral nutrition on intestine damage induced by severe burns.Methods Wistar rats were inflicted with 30% total body surface area full thickness burns and randomly divided into three groups:namely burned and enteral nutrition(EN), burned and parenteral nutrition(PN), and normal control(C). In EN and PN group, rats were supplied with equal volume, calorie, nitrogen and other nutrients. The following indices including the activity of diamine oxidase(DAO), the level of plasma endotoxin, index of intestinal epithelial proliferation and mucus layer depth were determined.Results After burn injury, the structure of intestine was severely damaged and the activity of DAO as well as plasma endotoxin was significant increased. On the other hand, intestinal epithelial proliferation index and mucus layer depth were remarked declined. As compared with PN, EN could abate intestine injury obviously, and lessen the degree of DAO and plasma endotoxin increased as well as intestinal epithelial proliferation index and mucus layer depth decreased, though it could not reverse this trend.Conclusion After burn injury, intestine mucosa are damaged and the ability of intestine epithelial cell proliferation is significant declined.Compare with parenteral nutrition, enteral nutrition is beneficial in minimizing intestine injury, promoting intestinal mucosa reparation