丹参肠内营养对危重患者肠屏障功能的保护研究  

Protective effects of salvia mltiorrhiza for enteral nutrition on the intestinal barrier function in critically ill patients

作　　者：徐杰[1] 窦若兰 蒋与刚[1] 孙志慧[1] 夏欣华[1] 任新生[1] 

机构地区：[1]天津市天和医院ICU,天津300050

出　　处：《中国中西医结合急救杂志》2005年第4期242-244,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：天津市卫生局重点科研基金资助项目(01KY17)

摘　　要：目的:探讨丹参肠内营养对危重患者肠道的保护作用。方法:将2003年11月—2004年8月收住本院重症监护治疗病房(ICU)的60例患者随机分为两组。丹参组30例,平均年龄(51.50±0.98)岁;能全力组30例,平均年龄(50.90±1.02)岁。根据疾病情况对两组患者进行常规治疗,同时每日给予肠内营养,持续治疗10d。在给予肠内营养前1d及给予肠内营养后第10d抽取静脉血,检测血前白蛋白(PAB)、超氧化物歧化酶(SOD)、丙二醛(MDA)、内毒素浓度以及外周血淋巴细胞DNA移动距离。结果:丹参组治疗后第10d血清内毒素水平为(1.70±0.08)kEU/L,明显低于能全力组的(1.97±0.11)kEU/L(P<0.05);血清SOD水平为(40.16±4.98)kNU/L,明显高于能全力组(34.50±3.02)kNU/L(P<0.05);血清MDA水平为(3.18±0.68)mmol/L,明显低于能全力组(4.91±0.47)mmol/L(P<0.01)。丹参组外周血淋巴细胞DNA移动距离为(20.68±0.85)μm,明显低于能全力组(22.69±1.36)μm(P<0.05)。结论:丹参肠内营养可通过减轻机体氧化损伤,保护肠道黏膜细胞,维护肠屏障功能,减少内毒素移位,从而阻止病情发展,减轻器官功能损害。Objective： To explore the protective effects of salvia miltiorrhiza for enteral nutrition （EN）on the intestinal barrier function in critically ill patients. Methods： Sixty patients in intensive care unit （ICU）from November, 2003 to August, 2004 were randomly divided into salvia miltiorrhiza for EN group, whose average age was 51.50±0.98, and nutrition fibre group （DS）, whose average age was 50.90±1.02. Patients of both groups were treated conventionally according to their conditions, meanwhile they were given salvia miltiorrhiza for EN every day for 10 days. The plasma prealbumin （PAB）, the superoxide dismutase （SOD）activity and malondialdehyde （MDA） content, endotoxin level and lymphocyte DNA shift distance were measured on the first day before EN and 10 th day after EN. Results： Ten days after treatment, the serum endotoxin level and MDA level in salvia miltiorrhiza for EN group were （1.70±0.08） kEU/L and （3.18±0.68） mmol/L, and they were significantly lower than those of DS group （1.97±0.11） kEU/L and （4.91±0.47） mmol/L （P〈0.05 or P〈0.01）. The serum SOD activity was （40.16±4.98） kNU/L in salvia miltiorrhiza for EN group, which significantly higher than those of DS group （34.50 ：t： 3.02） kNU/L（P〈0.05）. The lymphocyte DNA shift distance was （20.01±0. 88） μm, which was markedly lower than thatof DS group （22.69±1.36）μm （P〈0.05）. Conclusion： Salvia miltiorrhiza for EN could protect intestinal mucosa, maintain the intestinal barrier function by reducing the oxidative damage and decreasing the lipopolysaccharide translocarion.

关 键 词：丹参 肠内营养 前白蛋白 超氧化物歧化酶 丙二醛 内毒素 DNA损伤 

分 类 号：R459.3[医药卫生—治疗学]