肠外肠内营养对腹腔感染大鼠肠上皮紧密连接和屏障功能的影响  

Effects of enteral and parenteral nutrition on gut epithelial tight junction and immune barrier of rats with abdominal infection

作　　者：沈通一[1] 秦环龙[1] 佟大年[1] 高志光[1] 刘敏丰[1] 

机构地区：[1]上海交通大学附属第六人民医院外科,200233

出　　处：《中华普通外科杂志》2005年第3期174-176,共3页Chinese Journal of General Surgery

基　　金：国家自然科学基金资助项目 (3 0 471687)

摘　　要：目的　探讨肠外肠内营养对腹腔感染大鼠肠上皮紧密连接和屏障功能的影响。方法　14只存活6d的腹腔感染SD大鼠分别给予肠外营养(PN组)、肠外营养+肠内营养(PN +EN组)。两组动物供给等热、等氮量。第6天处死动物,取末段回肠和结肠采用免疫组化法测定其跨膜结合蛋白(occludin)表达及肠上皮浆细胞IgA表达并定量;取腔静脉血及肺、肝、肠系膜淋巴组织匀浆后作细菌培养测细菌易位率;取门静脉血经鲎试剂法检测内毒素含量。结果　PN +EN组小肠和大肠occludin及IgA表达明显优于PN组(P <0 .0 5及P <0 .0 1) ;血、肺、肝、肠系膜淋巴组织的细菌易位率和内毒素水平均低于PN组(P <0 .0 5 )。结论　肠内营养提高了肠上皮occludin表达,增加了肠道IgA的分泌,改善机械及免疫屏障,从而减少细菌易位。Objective To investigate the effect of enteral and parenteral nutrition on gut microecology in rats with abdominal infection. Methods Fourteen Sprague-Dawley (SD) model rats of abdominal infection, which had survived for more than 6 days were divided into two groups: PN group ( n =7) and PN+EN group ( n =7) via jejunostomy and jugular vein respectively for another 5 days. The nutrition support in the two groups was isonitrogen and isocaloric. At sacrifice on the sixth day, occludin and IgA level in plasma cells of intestine epithelium of the gut were measured by immunohistochemistry. Vena cava blood and homogenated tissue of liver, lung and mesenteric lymph nodes were cultured to determine bacterial translocations, and portal vein blood was tested for endotoxin. Results The expression of occludin and IgA in the small and large intestine in PN+EN group were stronger than PN group ( P <0.05, P <0.01). Bacterial translocations in blood, liver, lung and mesenteric lymph nodes, and the level of endotoxin were significantly reduced in PN+EN group ( P <0.05, P <0.01). Conclusion PN+EN may increase the expression of transmember binding proteins and IgA, maintaining the intestinal epithelial tight junction and the immune function, hence decreasing gut bacterial translocations.

关 键 词：肠外肠内营养 腹腔感染 屏障功能 紧密连接 肠上皮 occludin 细菌易位 肠外营养 膜结合蛋白 免疫组化法 内毒素含量 SD大鼠 细菌培养 组织匀浆 鲎试剂法 门静脉血 0.05 淋巴组织 免疫屏障 肠系膜 IgA tgA 浆细胞 表达及 动物 PN 

分 类 号：R459.3[医药卫生—治疗学]