肠内免疫营养对烫伤大鼠内毒素和CD14／肿瘤坏死因子-α mRNA表达的影响  

Effects of enteral immunonutrition on endotoxin and the expression of CD14/TNF-αmRNA in rats after thermal injury

作　　者：李悦[1] 蔡晨[2] 郭光华[1] 李国辉[1] 

机构地区：[1]江西医学院第一附属医院烧伤科,南昌330006 [2]安徽医科大学第一附属医院烧伤科

出　　处：《中华实验外科杂志》2005年第12期1442-1444,共3页Chinese Journal of Experimental Surgery

基　　金：江西省自然科学基金资助项目(0340078)

摘　　要：目的研究肠内免疫营养物对烫伤大鼠内毒素和CD14 mRNA、肿瘤坏死因子 (TNF)-α mRNA表达的影响及机制。方法致64只SD大鼠总体表面积(TBSA)30％Ⅲ度烫伤, 随机分为肠内免疫营养组(EIN组,32只)和标准肠内营养组(EN组,32只),另取8只大鼠作为伤前正常对照组(N组)。EIN组和EN组均给予等热量(125 Kcal／dl)肠内营养液。分别于伤前、伤后 1、4、7、10 d抽取静脉血和肝组织,检测血清内毒素和TNF-α浓度,RT-PCR检测肝组织CD14 mR- NA、TNF-α mRNA。结果烫伤后EN、EIN组血清内毒素、TNF-α浓度比伤前血清内毒素 (0．125±0．050)和TNF-α浓度(0．85±0．27)显著升高(P<0．01),且肝组织CD14 mRNA、TNF-α mRNA的表达明显增多;在伤后4、7、10 d,EIN组血清内毒素和TNF-α浓度以及肝组织CD14 mR- NA、TNF-α mRNA的表达均比EN组显著降低(P<0．05或P<0．01)。结论肠内免疫营养与标准肠内营养相比,可明显降低烫伤后血清内毒素水平,减少肝组织CD14 mRNA、TNF-α mRNA的表达,从而降低血清TNF-α浓度,改善烫伤后机体炎症反应。Objective To investigate the effects of enteral immunonutrition on endotoxin and the expression of CD14/TNF-α mRNA in severe scalded rats. Methods Sixty-four SD rats inflicted by 30% TBSA Ⅲ degree scalds were randomly divided into enteral immunonutrition （EIN, n = 32） group and enteral nutrition （EN, n = 32） group,The animals in two groups were fed with isocaloric enteral nutrition. The serum levels of endotoxin and TNF-α were determined at first, 4th, 7th and 10th day after injury. Simultaneously, the liver tissues were collected for the detection of the CD14 mRNA and TNF-α mRNA expression. Results Compared with pre-injury, the serum levels of endotoxin and TNF-α were significantly increased and the expression of CD14 mRNA and TNF-α mRNA in liver tissues also increased obviously in both groups. However the serum levels of endotoxin and the expression of CD14 mRNA, TNF-α mRNA in liver tissues in EIN group were significantly lower than those in EN group on the day 4, 7 and 10 post-injury （P〈0.05 or P〈0.01）.Conclusion Enteral immunonutrition superior to enteral nutrition in the early stage of sever scalded injury could decrease the serum levels of endotoxin and TNF-α, reduce the expression of CD14 mRNA and TNF-α mRNA in liver tissues and improve inflammatory responses.

关 键 词：肠内营养 烫伤 内毒素 CD14 TNF-α 大鼠 肿瘤坏死因子-Α mRNA 基因表达 

分 类 号：R644[医药卫生—外科学] R459.3[医药卫生—临床医学]