早期肠道喂养对烧伤后肾功能的保护作用及其可能机制

The protective effects on postburn renal function by early enteral feeding in burned rats

目的 研究早期肠道喂养 (EEF)对严重烧伤大鼠肾脏功能的保护作用及其可能机制。 方法 采用Wistar大鼠 30 %TBSA烫伤模型 ,动态观察了EEF对伤后胃黏膜内pH(pHi)、门静脉内毒素水平、肾组织含水量、血浆肿瘤坏死因子 (TNFα)、尿素氮 (BUN)、肌酐 (BCr)含量及内生肌酐清除率 (CCr)变化的影响。 结果 与烧伤对照组相比 ,EEF可明显遏制pHi降低、并减少门静脉内毒素、血浆TNFα及肾组织含水量 ;EEF不降低伤后BUN、BCr的浓度 ,但可使CCr增加 4.6 7倍 [( 16 .43± 2 .90 )vs ( 3.5 2± 0 .79) ,P <0 .0 1]。 结论 EEF对严重烧伤大鼠肾功能损害具有明显的改善作用 。

Objective To study the effects of enteral feeding on postburn renal function in rats and its possible mechanism. Methods Wistar rats inflicted with 30% TBSA skin burn were adopted as the model. The effects of early enteral feeding(EEF) were dynamically observed on the changes in intra-gastric mucosal pH(pHi), portal endotoxin level, renal water content, plasma level of tumor necrosis factor α(TNFα),serum BUN and Cr contents and endogenuous creatinine clearance rate(CCr). Results Compared with that in simple burn group, the pHi lowering could be inhibited by EEF, the portal endotoxin level, plasma TNFα level and renal water content were decreased by the action of EEF. Serum BUN, Cr contents were not affected by EEF. But the CCr increased by 4.67 fold[ from (16.43±2.9) to (3.52±0 79), P < 0 01] with EEF. Conclusion EEF could obviously improve postburn renal function in severely burned rats, which might be related to the decrease of enteral endotoxin translocation and the postburn release of inflammatory mediators.