早期肠内营养对急性重症胰腺炎大鼠肠道粘膜屏障的保护作用

Early enteral nutrition can improve intestinal mucosal barrier in severe acute pancreatitis in rats

目的 探讨早期肠内营养对急性重症胰腺炎大鼠肠道粘膜屏障的保护作用。方法 SD大鼠48只,随机分成6组(n=8):急性重症胰腺炎全肠外营养1天组(A组),模拟手术全肠外营养l天组(B组),急性重症胰腺炎全肠外营养5天组(C组)和肠内营养5天组(E组),模拟手术全肠外营养5天组(D组)和肠内营养5天组(F组)。采用逆行胰胆管注射3％牛磺胆酸钠溶液制成重症胰腺炎大鼠模型。E组和F组术后先予肠外营养,48h后开始肠内营养。观察大鼠的空肠组织形态学变化及空肠粘膜固有层CD4^+/CD8`+比值。结果 急性重症胰腺炎大鼠均无死亡,E组和F组大鼠对肠内营养耐受良好。C组的CD4^+/CD8^+比值明显低于D组。E组的空肠绒毛高度和CD4`+/CD8`+比值明显高于C组。结论 重症胰腺炎大鼠肠道粘膜屏障功能受损,早期肠内营养可改善重症胰腺炎大鼠的肠道粘膜屏障功能。

Objective To investigate the protective effect of early enteral nutrition (EN) on intestinal mucosal barrier in severe acute pancreatitis (SAP) in rats. Methods 48 SD rats were equally randomized into 6 groups(n =8): SAP was induced in rats of groups A, C and E. Rats of groups B, D and F underwent laparotomy without induction of SAP. Groups A-D received total parenteral nutrition(TPN) , while groups E and F received TPN within 48 hours following EN. Animals in groups A and B were sacrificed at 24 hours postoperation while animals in the other groups were sacrificed at 120 hours postoperation. The villus height, crypt depth of the jejunal mucosa and the number of CD4+ and CD8+ lymphocytec of lamina propria were analyzed. The CD4+/CD8+ ratio was calculated. Results None of the rats died. The CD4+/CD8+ ratio was significantly lower in group C than in group D. The villus height and CD4+/CD8+ ratio in group E were significantly higher than those in group C. Conclusions The intestinal mucosal barrier was damaged in SAP in rats. Early enteral nutrition was able to improve the intestinal mucosal barrier in SAP in rats.