生长激素和谷氨酰胺对脓毒症大鼠细胞因子和氨基酸代谢的影响  

Effects of Glutamine Combined with Growth Hormone on Cytokine and Amino Acid Metabolism in Septic Rats

作　　者：刘敏丰[1] 高志光[1] 秦环龙[1] 

机构地区：[1]上海交通大学附属第六人民医院外科,上海200233

出　　处：《中国普外基础与临床杂志》2006年第5期535-539,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：上海市卫生发展科技基金重点资助项目(编号:024119039)

摘　　要：目的探讨谷氨酰胺(Gln)联合生长激素(GH)对脓毒症大鼠肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、IL-6、皮质醇及三甲基组氨酸(3-MH)浓度和氨基酸代谢的影响。方法79只SD大鼠,随机取其中10只设为对照组,另69只用盲肠结扎穿孔法建立腹腔感染、颈静脉置管肠外营养(PN)模型后,将其中存活超过6d的大鼠30只均分为3组:脓毒症组、Gln组和Gln+GH组。第6d处死动物,取门静脉血,用酶联免疫吸附法(ELISA)检测血清TNF-α、IL-1、IL-6和皮质醇浓度;氨基酸自动分析仪检测血清氨基酸浓度;取大鼠趾长伸肌组织,采用高效液相色谱法检测骨骼肌组织中3-MH浓度。结果血清TNF-α、IL-1、IL-6及皮质醇浓度对照组均低于脓毒症组(P<0.05,P<0.01),Gln+GH组及Gln组均低于脓毒症组(P<0.05,P<0.01),Gln+GH组亦低于Gln组。与对照组相比,脓毒症组血清总氨基酸浓度升高(P<0.05),尤以谷氨酸和支链氨基酸明显(P<0.05),Gln浓度明显降低(P<0.05);Gln组和Gln+GH组与脓毒症组相比,血清总氨基酸浓度降低(P<0.05),尤以Gln+GH组降低明显(P<0.05),Gln浓度明显升高(P<0.05)。骨骼肌组织中3-MH浓度以脓毒症组为最高,Gln组又高于Gln+GH组(P<0.01)。结论添加GH和Gln的PN,能降低细胞因子水平,改善氨基酸代谢。Objective To study the effects of glutamine （Gin） combined with growth hormone （GH） on the levels of cytokine （TNF-α, IL-1, IL-6）, coritsol and amino acid metabolism in septic rats. Methods Ten out of 79 SD rats were randomly collected as the control group. Thirty of 69 septic SD rats, which were made by cecal ligation and perforation （CLP） method and were given parenteral nutrition （PN） lived to day 6. They were also randomly divided into three groups as follows., septic group （n= 10）, parenteral supplemented glutamine group （Gin group, n=10）, andGln combined with GH （Gln＋GH group, n=10）. On the 6th day, blood drew from portal veins of the dead rats was used to detect the levels of TNF-α, IL- 1, IL-6 and cortisol by ELISA. The plasma concentrations of free amino acids were determined by amino acid auto analyzer. The muscle tissue of extensor digitorum longus was used to determine 3-methyl histidine （3-MH） by high performance liquid chromatographic （HPLC）. Results Except for the control group, most rats developed celiac abscess, hepatic abscess and pulmonary infection. The serum levels of TNF-α, IL- 1, IL-6 and cortisol were significantly higher in the septic group than those of the other three groups, and they were significantly lower in theGln＋GH group than those of the Gln group, P〈0.05. Compared with the other three groups, the concentration of total amino acid in the septic group increased more, among which the glutamine and the branched chain amino acids were prominent. Most of concentrations of the amino acids decreased in the Gin group and the Gln＋GH group, and the decreased amplitude of the Gln＋GH group was larger, P〈0.05, albeit its level of Gin markedly increased. The concentration of 3-MH in muscle tissue was the highest in septic group, and it was significantly higher in the Gin group than that of the Gln＋GH group, P〈0.01. Conclusion It may be necessary to supplement GH combined with Gin as the content of PN to decrease cytokine levels and im

关 键 词：脓毒症 氨基酸 谷氨酰胺 生长激素 细胞因子 

分 类 号：R96[医药卫生—药理学]