完全胃肠外营养对肠道免疫功能的影响  

Effects of total parenteral nutrition on intestinal immunity

作　　者：张雷华[1] 王俊义[1] 宋维亮[1] 

机构地区：[1]第四军医大学西京医院胃肠外科

出　　处：《第四军医大学学报》1996年第1期30-32,共3页Journal of the Fourth Military Medical University

摘　　要：目的：研究完全胃肠外营养（ＴＰＮ）对肠道免疫功能的影响．方法：采用大鼠ＴＰＮ模型，分离培养肠道粘膜淋巴细胞，测定肠道白细胞介素２（ＩＬ－２）；取肠系膜淋巴结进行细菌学研究，测定细菌易位率．实验共使用２００～２５０ｇ体重ＳＤ大鼠７２只，随机分组：对照１组（ｎ＝２０），对照２组（ｎ＝２０），ＴＰＮ１组（ｎ＝１６），和ＴＰＮ２组（ｎ＝１６）．对照组仅行假手术，即行右颈静脉结扎，每日饲以普通饲料及水．ＴＰＮ组禁食水，输注常规ＴＰＮ．其中对照１组与ＴＰＮ１组观察７ｄ，对照２组与ＴＰＮ２组观察１４ｄ．结果：ＴＰＮ７ｄ和１４ｄ的细菌易位率分别是４４％，６３％，明显高于对照组（Ｐ分别小于０．０５，０．０１）；肠道ＩＬ－２活性随ＴＰＮ时间延长逐渐降低（Ｐ＜０．０１）．Objective: To explore the effects of total parenteral nutrition (TPN) on intestinal immunity. Methods: Seventy two Sprague Dowley rats (200～250 g) were divided at random into four groups: Group A (Control group Ⅰ, n =20) and Group B (Control group Ⅱ, n =20) received sham operation and were fed with normal rat chow and water adlibitum, Group C (TPN group Ⅰ, n =16) and Group D (TPN group Ⅱ, n =16) were put in fasting state and received a standard formula of TPN. Animals in Group A and C were observed for 7 d, while in Group B and D for 14 d. The lamina propria lymphocytes were isolated and cultured for measuring interleukin 2 (IL 2) of intestine. Mesenteric lymph nodes were harvested for bacterial study. Results: The control animals had no bacterial translocation. The rates of bacterial translocation increased with duration of TPN from 44% (7 d TPN, P <0.05 vs control) to 63% (14 d TPN, P <0.01 vs control). IL 2 activity decreased significantly with the duration of TPN from (12746±1426) cpm (7 d TPN, P <0.05 vs control) to (11015±1192) cpm (14 d TPN, P <0.01 vs control). Conclusion: Pronlonged use of TPN leads to intestinal immunodificiency and promotes bacterial translocation.

关 键 词：胃肠外高营养 肠道 免疫功能 

分 类 号：R459.3[医药卫生—治疗学]