中链三酰甘油对短肠综合征大鼠脂肪代谢和肠道代偿的影响  

Effect of enteral supplement of medium chain triglyceride on fat metabolism and intestinal adaptation in rats with short bowel syndrome

作　　者：蒋小华[1] 朱维铭[2] 李宁[2] 黎介寿[2] 

机构地区：[1]东南大学附属中大医院普通外科,江苏南京210009 [2]南京军区南京总医院解放军普通外科研究所,江苏南京210002

出　　处：《肠外与肠内营养》2007年第6期334-337,共4页Parenteral & Enteral Nutrition

摘　　要：目的：研究肠内营养（EN）中添加中链三酰甘油（MCT）对广泛肠切除术后大鼠脂肪代谢和肠道代偿的影响。方法：体质量220～250gSD大鼠27只，随机分为三组。假手术对照组（Con组）行空肠横断吻合，长链三酰甘油（LCT）短肠组（LSB组）和中、长链甘油三酯（MCT／LCT）短肠组（MSB组）均行85％中段小肠切除。各组大鼠于术后第2～14天，分别给予等氮和等热量的EN支持，其中Con组和LSB组EN的脂肪均为LCT，MSB组EN的脂肪含50％LCT和50％MCT。术后每天监测体质量变化；术后第12～14天检测脂肪吸收率；术后第15天处死动物，取血检测血浆总游离脂肪酸及必需脂肪酸水平，称量空肠及回肠重量、空肠及回肠黏膜重量，检测空肠及回肠黏膜DNA及蛋白质含量；行小肠病理检查，测量空肠及回肠黏膜绒毛高度、隐窝深度和黏膜厚度，并检测空肠和回肠黏膜增殖细胞核抗原（PCNA）和细胞凋亡情况。结果：大鼠广泛肠切除术后出现明显的肠道代偿。MSB组的脂肪吸收率、血清总游离脂肪酸及必需脂肪酸水平显著高于LSB组；MSB组在体质量、肠黏膜重量、肠黏膜DNA及蛋白质含量、肠黏膜病理（绒毛高度、隐窝深度和黏膜厚度）、肠黏膜细胞增殖及凋亡与LSB组比均无显著性差异。结论：添加50％MCT的EN较单纯LCT的EN更能增加短肠综合征大鼠对脂肪的吸收，增加血清游离脂肪酸水平，而不影响肠道代偿。Objective：To determine the effect of enteral supplement of medium chain triglyceride on fat metabolism and intestinal adaptation in rats with short bowel syndrome （SBS）. Methods ： Male Sprague- Dawley rats were randomly assigned to one of the three groups： sham rats fed 30% LCT enteral nutrition （ Con）, SBS rats fed 30% LCT enteral nutrition（LSB） and SBS rats fed 30% MCT/LCT（ MCT： LCT = 1 ：1 ） enteral nutrition（MSB）. SBS rats received 85% mid small bowel resection, and sham rats received sham operation. All animals received isonitrogenic and isocaloric enteral nutrition. Fat absorbability, plasma free fatty acids, parameters of intestinal adaptation （body weight, jejunal and ileal weight, jeju- nal and ileal mucosal weight, jejunal and ileal mucosal DNA and protein content, jejunal and ileal villus length, crypt depth, mucosal thickness）, enterocyte proliferation and apoptosis were determined. Results：After massive small bowel resection, rats had significant bowel adaptation. Compared with LSB rats, MSB rats demonstrated a significant increase in fat absorbability, serum total FFA and serum EFA levels. No significant difference was found between MSB rats and LSB rats in body weight, intestinal weight, mucosal DNA and protein content, intestinal mucosal villus length, crypt depth and mucosal thickness, enterocyte proliferation and apoptosis. Conclusion：In a rat model of SBS, moderate enteral supplement of medium chain triglyceride appears to increase fat absorbability, serum FFA levels, but does not inhibit intestinal adaptation.

关 键 词：短肠综合征 肠道代偿 中链三酰甘油 长链三酰甘油 

分 类 号：R574[医药卫生—消化系统]