添加短链脂肪酸的TPN对大鼠晚期结肠癌吻合口愈合的研究  

Effects of Total Parenteral Nutrition Supplemented with Short-Chain Fatty Acids on Healing of Colon Stoma in Rats after Tumorectomy

作　　者：傅侃达[1] 秦长江[1] 王国柱[2] 

机构地区：[1]河南大学淮河医院普外科,开封市475000 [2]南京医科大学第一附属医院普外科,南京市210029

出　　处：《医药论坛杂志》2010年第24期33-35,39,共4页Journal of Medical Forum

摘　　要：目的研究添加短链脂肪酸(Short Chain Fatty Acids,SCFA)的全肠外营养(Total Parenteral Nutri-tion,TPN)对晚期结肠癌大鼠模型结肠吻合口愈合的影响。方法应用瘤块转移法建立晚期结肠癌大鼠Ⅰ期结肠吻合模型,随机分为2组①SCFA组,于常规TPN液中添加SCFA②TPN组行常规TPN。术后第6天处死大鼠,标本作病理组织学检查,行肠系膜淋巴结细菌培养,检测黏膜细胞的DNA周期及Ⅰ型胶原蛋白的表达。结果光学显微镜下和透射电镜下均可见SCFA组吻合口胶原纤维粗大、密集,并趋向与肠轴平行排列;对照组结肠黏膜细胞增殖期(S期)百分比(6.23±2.75)显著低于SCFA组(11.57±3.54,P=0.001);Ⅰ型胶原蛋白显示棕黄色颗粒位于细胞浆内,SCFA组表达明显,对照组不明显。对照组肠系膜淋巴结细菌培养的阳性率和菌落计数(1.90±1.06)显著高于SCFA组(0.84±1.14,P=0.025)。结论添加SCFA的TPN能减少肠道菌群易位,保护结肠黏膜的屏障功能,能促进荷瘤状态下大鼠结肠上皮细胞的增殖,增强结肠吻合口的胶原代谢和蛋白质合成,促进Ⅰ型胶原蛋白的表达,促进结肠吻合口的愈合。Objective The purpose of this study was to study the effects of TPN supplemented with SCFA on the healing of colon anastomosis in rats and to explore the possible mechanism of the SCFA. Methods Develop the rats model of colon carcinoma in advanced stage by the way of LUMPS TRANSPLANT,after 4 weeks the tumor succeed to built on colon were cut and the intestinal anastomosis were processed 20 rats were randomly divided into two groups,with 10 in each.SCFA group routine TPN supplemented with SCFA formulated in proportion,TPN group（control group）,which were with routine TPN.On 6th day after operation,The pathological changes were observed in each group,with aseptic technique mesenteric lymph nodes were collected for germiculture.The cycle of colon mucosal cells was detected through flow cytometry（FCM）,the expression of collagen-I was observed through immunohistochemical method. Results In SCFA group,the collagen fibers were thick,dense,and tended to arrange parallelly to the intestinal axis.In the control groups the percentage of colon mucosal cells at the proliferative stage（Stage S）（6.23±2.75） was significantly lower than that of the SCFA group（11.57±3.54,P=0.001）.It was observed that collagen-I was located in the cytochylema in the form of brownish granules.The expression of collagen-I was evident in the SCFA group and the least evident in the control group.Bacterial translocation rate in mesenteric of mesenteric lymph nodes in thecontrol was higher than the SCFA group. Conclusion TPN supplemented with SCFA reduces the translocation of enteric bacteria and maintain the barrier of colon mucosa.TPN supplemented with SCFA promotes the proliferation of colon enterocyte in rats and the formation of collagen protein,increases the strength of anastomotic segment of colon and helps the healing of colon anastomosis.

关 键 词：短链脂肪酸 晚期结肠癌 全胃肠外营养 结肠吻合口 

分 类 号：R-332[医药卫生]