不同营养支持途径对烧伤大鼠肠粘液屏障的影响

Effect of different routes on the intestinal mucus barrier in scalded rats

目的 观察不同营养支持途径对烧伤大鼠肠粘液屏障的影响并探讨其机制。方法 采用 3 0 %TBSAⅢ度烧伤大鼠模型 ,随机分成伤前对照组 (C组 )、静脉营养组 (PN组 )及肠道营养组 (EN组 ) ,EN组和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肠粘液层厚度、粘液中蛋白质、己糖及唾液酸的含量。 结果 烧伤后肠粘液层变薄 ,粘液中蛋白质、己糖和唾液酸的含量明显低于伤前。两组相比EN组大鼠肠粘液层厚度、粘液中己糖和唾液酸的含量均明显高于PN组 ,而粘液中蛋白质含量两组相差不显著。 结论 严重烧伤后杯状细胞合成粘液的能力下降 ,肠粘液层变薄 ,粘液成分改变。与静脉营养相比 ,肠道营养可减轻伤后杯状细胞受损程度 ,促进肠粘液合成 ,维持肠粘液化学成分的稳定 。

Objective To observe the effect of different nutritional routes of giving nutrition on the intestinal mucus barrier in severely scalded rats. Methods Wistar rats inflicted with 30% TBSA III degree scalding on the back were employed as the model and were randomly divided into 3 groups, i.e.control (C), parenteral nutrition (PN) and enteral nutrition (EN) groups. The rats in PN and EN groups were supplied with equal amount of nitrogen and calories and with equal volume of nutrition solution. The dynamic changes in the thickness of intestinal mucus layer and the contents of protein, hexose and acetylneuraminate in the mucus were examined. Results When compared with those in C group, the intestinal mucus layer became thinner and the contents of protein, hexose and acetylneuraminate in the mucus in both PN and EN groups decreased evidently after scalding. When compared between two nutritional groups, the thickness of intestinal mucus layer and the contents of the hexose and acetylneuraminate in the mucus in EN were much thicker and higher than those in PN group, while the mucus protein content exhibited no obvious difference between PN and EN groups. Conclusion It was suggested that intestinal goblet cell synthesized and secreted less mucus after scalding in rats resulting in thinning of intestinal mucus layer and the change in mucus components. When compared with those in PN group, less injury to the intestinal goblet cells occurred and the intestinal mucus synthesis was less affected in EN group, and the components of intestinal mucus were maintained stable.