经空肠内营养对急性胰腺炎犬胰液分泌、氨基酸摄取和酶蛋白合成的影响

Effects of Early Intrajejunal Nutrition on Pancreatic Secretion,Amino Acid Uptake and Enzyme-protein Synthesis in Acute Pancreatitic Dogs

目的探讨经空肠内营养(EIN)对急性胰腺炎犬胰液分泌、腺泡细胞氨基酸摄取及亚细胞成分中酶蛋白合成的影响。方法15只杂种犬在急性胰腺炎模型制成后,随机分为肠外营养(PN)组(n=7)和EIN组(n=8)。在造模后营养支持的第1天、第7天作胰腺外分泌刺激试验(pancreaticexocrinesecretionstimulationtest,PESST),即在营养液起始输注的同时,5min内静脉注入1.85×106BqL-3H-苯丙氨酸,连续观察30、60、120、180min各时相点腺泡细胞氨基酸摄取及亚细胞成分酶蛋白合成的变化;累计3h胰液分泌、淀粉酶、蛋白、HCO3-、Cl-、Na+和K+含量。结果第1天、第7天的180min内两组间胆汁、十二指肠液、胰液量及其中的淀粉酶、脂肪酶含量和电解质HCO3-、Cl-、Na+、K+含量的差异均无显著性。第1天PESST表现为:两组腺泡细胞、亚细胞成分溶酶体-线粒体、微粒体的放射活性均在60min时相点达高峰,下降幅度缓慢,两组差异无统计学意义(P>0.05);第7天重复PESST结果显示,上述指标的变化基本类似于第1天,在60min的值均比第1天为高,但下降幅度较大,随后各时相点变化两组比较差异无显著性(P>0.05)。结论EIN可能不产生刺激胰液分泌、增加胰腺酶蛋白合成,加重胰腺负担的作用。

Objective This study was to evaluate effects of intrajejunal nutrition on pa ncreatic secretion,amino acid uptake and enzyme-protein synthesis in acute pan creatitic dogs.Methods 22dogs with acute pancreatitis(AP)model were induced by injecting1ml /kg of combined solution of5%sodium taurocholate and8000 ～10000BAEE units trypsin/ml into pancrease via pancreatic duct.15dogs with AP survival over7d(death rate31.8%)were divided into PN group(n= 7)and EIN group (n=8).Two groups were isonitrogenous and isocaloric.EIN was used at postoperative24h.Nutrison was the major energy source.The amoun t of biliary juice,duodenal juice,pancreatic juice,amylase,pancreatolipase and HCO 3-?Cl-?Na + ?K + were determined.Pancreatic exocrine secretion stimulation test(PESST)were determined at the first day and seventh day,radioactive tracing was used to ev aluate the change of amino acid uptake,enzyme-protein synthesis in acinar cell and subcellular fractionation after injecting L-3 H phenylalanine30,60,120,180min following the PN or EIN on the first and seventh day.Results The changes of biliary juice,duodenal juice,pan creatic juice, amylase,pancreatolipase and HCO 3-,Cl-,Na + ,K + between the two groups did not reach statistically significant difference level on the first day and7th day(P>0.05).PESST of the first day showed that the radioactivity of L-3 H phenylalanine uptake by pancreatic acinar cells and incorporations of L-3 H phenylalanine into newly synthesized enzyme-protein reached peak le vel at60min,the radioactivity of 3 H in EIN group were higher than those in PN group(P<0.05),and then g radually decrease.The peak level of radioactivity of 3 H reached at60min in zymogen granule,lysosomal-mitochondria and microsoma l subcellular fractionation,the two latter gradually decreased,their changes were not significantly different at the latter times(P>0.05).PESST on t he seventh day showed that these results were similar to PESST on the first day ,the radioactivity of 3 H at60min was higher than those at the first day,the decline rate was hig her as compared with PESST at the first day.Conclusions Early intrajejunal nut rition did not stimulate pancreatic acinar amino acid uptake and enzyme-protein synthesis,and not increase the overload of pancreatic exocrine secretion.