肠康复治疗对短肠综合征病人残余小肠黏膜形态学的影响  

The effect of growth hormone,glutamine and optimal diet fiber enteral nutrition on intestinal mucosal morphology in patients with short bowel syndrome

作　　者：郭明晓[1] 李幼生[1] 李元新[1] 吴波[1] 汪志明[1] 王剑[1] 王凯[1] 黎介寿[1] 

机构地区：[1]南京大学医学院临床学院(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》2011年第6期326-330,共5页Parenteral & Enteral Nutrition

摘　　要：目的:观察重组人生长激素(rhGH)、谷氨酰胺(Gln)和膳食纤维的肠内营养(EN)对短肠综合征病人小肠黏膜形态、肠黏膜细胞增殖和凋亡水平的改变,以评价对短肠综合征病人的治疗效果。方法:10例短肠综合征病人联合应用rhGH 0.05 mg/(kg.d)、Gln 30 g/d和膳食纤维的EN进行3周的肠康复治疗。分别在治疗前、后检测病人残余小肠黏膜形态以及细胞增殖、凋亡水平。结果:10例短肠综合征病人均完成肠康复治疗。治疗后病人残余小肠绒毛高度显著增加(P<0.05),隐窝深度轻度增加(P>0.05)。治疗后小肠黏膜隐窝增殖细胞核抗原Ki-67表达显著高于治疗前(P<0.01),肠上皮细胞Caspas-3的活性轻度降低(P>0.05)。结论:联合应用rhGH、Gln和膳食纤维的EN,可有效地促进短肠综合征病人残余肠道黏膜形态学代偿反应。Objectives： To investigate the effect of growth hormone（GH）,glutamine（Gln） and optimal diet fiber enteral nutrition on the morphology of intestinal mucosa in patients with short bowel syndrome（SBS）.Method： Ten patients with SBS received GH（0.05 mg/kg/day）,oral Gln（30 g/d）,plus optimal diet for 3 weeks.Intestinal mucosal morphology,proliferating and apoptotic status were investigated before and after treatment.Result： All patients completed the treatment.Intestinal mucosal villus height were significantly improved after treatment（P0.05）.Intestinal mucosal crypt depth was slightly increased but there was no statistical significance（P0.05）.The proliferation levels of the small bowel was increased（P0.05）,the apoptotic status was slightly increased but there was no statistical significance（P0.05）.Conclusion： Treatment with GH,Gln and optimal diet fiber enteral nutrition has positive effect on intestinal mucosal morphology in patients with short bowel syndrome.

关 键 词：生长激素 谷氨酰胺 营养 肠康复 短肠综合征 

分 类 号：R656.7[医药卫生—外科学]