早期肠内免疫营养对烫伤大鼠免疫功能的影响  

The influence of early enteral immunonutrition on immunological function of body and intestine in severely scalded rats

作　　者：郭光华[1] 蔡晨[2] 范骏[1] 张红艳[1] 李国辉[1] 

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

出　　处：《中华烧伤杂志》2007年第4期257-260,共4页Chinese Journal of Burns

基　　金：江西省自然科学基金(0340078)

摘　　要：目的了解早期肠内免疫营养对烫伤大鼠全身及肠道免疫功能的影响。方法将健康SD大鼠分为标准营养组(EN组)和免疫营养组(EIN组),每组32只。将两组大鼠制成烧伤总面积30%TBSA的Ⅲ度烫伤模型,于伤后1、4、7、10 d检测其外周血T淋巴细胞亚群、肠黏膜增殖细胞核抗原(PCNA)表达水平、浆细胞数量及肠黏液分泌型免疫球蛋白A(S-IgA)含量的变化。另取8只健康大鼠检测上述指标作为正常参考值。结果(1)与正常值比较,伤后EN组CD3^+、CD4^+、CD4^+、CD8^+降低但CD8^+升高,与各项指标大部分时相点比较,差异有统计学意义(P<0.05或P<0.01)。伤后10 d与EN组(CD4^+/CD8^+为1.26±0.10)比较,EIN组CD3^+、CD4^+、CD4^+/CD8^+(CD4^+/CD8^+为1.86±0.25)升高而CD8^+下降(P<0.01)。(2)伤后4、7、10 d,EIN组肠黏膜PCNA表达水平、浆细胞数量及肠黏液S-IgA含量较EN组明显升高(P<0.05或P<0.01)。结论烫伤后早期给予肠内免疫营养,可以提高全身及肠道免疫功能,效果优于标准肠内营养。Objective To investigate the influence of early enteral immunonutrition on immunological function of body and intestine in severely scalded rats. Methods Sixty-four healthy adult SD rats were subjected to 30% TBSA full-thickness scald and randomly divided into enteral nutrition group （ EN, n = 32） and enteral immunonutrition group（ EIN, n = 32）. Another 8 healthy rats were enrolled as normal controls. The changes in CD3 ^＋ , CD4 ^＋ , CD8 ^＋ T lymhocyte subsets, the PCNA expression in intestinal mucosa,the amount of plasmocytes in lamina propia of small intestine and the content of s-IgA in small intestine were determined on 1,4, 7 and 10 post-burn days （PBD）. Results （ 1 ） CD3 ^＋ , CD4 ^＋ and the ratio of CD4 ^＋ / CD8 ^＋ were remarkably declined, while CD8 ^＋ was obviously raised after scald in EN group, and there were statistically significant differences at most of time-points when compared with those in control group （ P 〈 0.05 orP 〈0.01）. CD3 ^＋,CD4 ^＋ and the ratio ofCD4 ＋/CD8 ^＋on7 and 10 PBD in EIN group were obviously higher （increased from 4 PBD on, and it was 1. 86 ± 0.25 on 10 PBD） than those in EN group （ CD4 ^＋/CD8 ^＋ was 1.26 ±0.10 on 10 PBD） , while CD8 ^＋ in EIN group was evidently lower than that in EN group（ P 〈0.01 ）. （2） The level of PCNA expression in intestinal mucosa,the amount of plasmocytes in lamina propia of small intestine and the content of s-IgA in small intestine in EIN group were increased significantly compared with EN group on 4,7,10 PBD（ P 〈0.05 or P 〈 0.01 ）. Conclusion Early enteral immunonutrition can improve immunological function of body and intestine after severe scald, with better resuits than enteral nutrition.

关 键 词：烧伤 肠道营养 免疫 谷氨酰胺 精氨酸 

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