膳食纤维对溃疡性结肠炎患者黏膜屏障功能的保护  

Dietary fiber in protection of intesfinal mucosal barrier in patients with ulcerative co].itis

作　　者：王东亮[1] 陈德国[1] 武华[1] 

机构地区：[1]山西医科大学第一医院普外科,太原030001

出　　处：《国际医药卫生导报》2013年第1期3-5,共3页International Medicine and Health Guidance News

基　　金：黎介寿院士肠道屏障研究专项基金（LJS-201024）

摘　　要：目的探讨添加复合膳食纤维的肠内营养对溃疡性结肠炎患者黏膜屏障功能的保护作用。方法给予溃疡性结肠炎患者口服柳氮磺胺毗啶（SASP）1．0g，4次，d，将治疗2周后病情未向重度转化的90例用随机数字表法分人三组行肠内营养治疗。C组：单纯能全素组；T1组：能全素＋膳食纤维组（每500 kcal肠内营养液添加复合膳食纤维7．5g，其中可溶性与不溶性膳食纤维1：2）；T2组：能全素＋膳食纤维组（每500 kcal肠内营养液添加复合膳食纤维7．5g，其中可溶性与不溶性膳食纤维1：3）。分别于肠内营养治疗前及治疗7d后检测患者血浆中肿瘤坏死因子-α（TNF-α）及内毒素（endotoxin，E邴含量。结果肠内营养治疗7d后，血浆中TNF-α浓度T1组[（144．5±20．0）ng／L]、T2组[（140．6±19．2）ng／L]明显低于C组[（170．7±30．4）ng／L]（P〈0．05），T1组与T2组间差异无统计学意义（P〉0．05）；血浆中ET浓度T1组[（0．137±0．018）Eu／m1]、T2组[（0．130±0．017）Eu／m1]明显低于C组[（0．156±0．012）Eu／m1]（P〈0．05），T1组与T2组间差异无统计学意义（P〉0．05）。结论添加适量的复合膳食纤维的肠内营养可以降低肠黏膜的通透性，保护溃疡性结肠炎患者的肠黏膜屏障功能。Objective To explore the protective effect of enteral nutrition （EN） containing dietary fibercomplex （DFC） in intestinal mucosal barrier function in patients with ulcerative colitis. Methods The patients with ulcerative colitis received sulfasalazine tablets of 1.0 g four times daily for two weeks. Then 90 of the patients whose symptoms did not become severe were randomly divided into three groups. Group C received uo-DFC nu- trition, while group T1 and T2 separately received EN with soluble dietary fiber or insoluble dietary fiber （every 500 kcal of EN with 7.5 g DFC） in certain proportion of 1 ： 3. Before and after a 7-day treatment, plasma con- centrations of TNF- α and endotoxin （ET） were detected. Results 7 days after therapy with EN, concentration of TNF- -α （144.5 ±- 20.0） ng/L in group T1 and （140.6 ± 19.2） ng/L in group T2 was markedly lower than that in group C （170.7 ± 30.4） ng/ （P〈0.05）, while the difference between groups T, and T2 had no statistical signifi- cance （P〉0.05）. Concentration of ET （0.137 ± 0.018） Eu/ml in group T, or （0.130 ± 0.0 17） Eu/ml in group T2 was lower than that in group C （0.156 ± 0.012） Eu/ml （P〈0.05）, and there was no statistical difference between groups T1 and T2 （P〉0.05）. Conclusions Enteral nutritio~ containing proper amount of dietary fiber complex can reduce intestinal permeability and protect intestinal mucosal barrier function in patients with ulcerative colitis.

关 键 词：溃疡性结肠炎 黏膜屏障 膳食纤维 瘤坏死因子 内毒素 

分 类 号：R57[医药卫生—消化系统] R45[医药卫生—内科学]