肠内免疫微生态营养对大鼠重症急性胰腺炎急性肺损伤保护作用的研究  

The protective effect of ecoimmunonutrition on severe acute pancreatitis induced acute lung injury

作　　者：康利民 郑永 杨文雄 王阿勇 施红宁 

机构地区：[1]云南省普洱市人民医院肝胆胰外科,云南普洱665000

出　　处：《肝胆胰外科杂志》2015年第5期390-393,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨肠内免疫微生态营养对重症急性胰腺炎(SAP)大鼠急性肺损伤(ALI)的影响。方法将大鼠分为空白组、SAP-ALI组,肠内营养组(EN组)和肠内免疫微生态营养组(EIN组),大鼠SAP采用牛磺胆酸钠造模,EN及EIN组于造模成功后行相应肠内营养支持。72 h后处死大鼠后取肺脏,观察肺组织形态学变化、计算肺损伤评分和湿/干重比;免疫组化检测肺组织TLR 4、NF-κB p65的表达;ELISA法测定血清TNF-α、IL-1β含量。结果与空白组相比,SAP-ALI组肺损伤评分、肺湿/干重比、TNF-α、IL-1β均明显升高(P<0.05);免疫组化结果发现,与空白组相比,SAP-ALI组TLR 4、NF-κB p65表达显著增强(P<0.05);与SAP-ALI组、EN组相比,EIN组TLR 4、NF-κB p65表达显著降低(P<0.05);并且EIN组血清肺损伤评分、肺湿/干重比、TNF-α、IL-1β与SAP-ALI组、EN组比较均显著降低(P<0.05)。结论肠内免疫微生态营养有助于降低肠源性内毒素(LPS)的产生,进而降低TLR 4/NF-κB信号通路的激活,从而减轻SAP-ALI的病情。Objective To discuss the role of ecoimmunonutrition （EIN） on severe acute pancreatitis （SAP）induced acute lung injury （ALl） of ratsl Methods SD rats were randomly divided into control group, SAP-ALl group, enteral nutrition （EN） group and EIN group. The model of SAP was established by injecting 4% sodium taurocholate （1 mL/kg） into the pancreatic duct of the rats. The EN group and EIN groups were given the appropriate nutritional support way after the SAP rat model was successfully performed. The rats were sacrificed at 72 h after the beginning of building animal models. The histopathologic changes in lung were observed, and the lungs injure score and wet/dry of lung tissue were calculated. The expressions of TLR 4, NF-κB p65 in the lungs were detected by immunohistochemistry. Serum levels of TNF- α, IL-1β by ELISA were determined. Results Compared with control group, the lung injure score, wet/dry of lung tissue, TNF-α, IL-1β in SAP-ALl group were significantly higher （P〈0.05）. The expression of TLR 4 and NF- κB p65 in lung tissue of SAP-ALl group were significantly higher than that in the control group （P〈0.05）. The expression of TLR 4 and NF-κB p65 in lung tissue of EIN group were decreased significantly than SAP-ALl group and EN group （P〈0.05）. Compared with SAP-ALl group and EN group, the lung injure score, wet/dry of lung tissue, TNF- α and IL- 1β in EIN group were significantly decreased （P〈0.05）. Conclusion Ecoimmunonutrition can significantly reduce the level of LPS, and can inhibit the expression of TLR 4 and NF-κB p65 in lung tissue and down-regulate the expression of TNF- α and IL- 1 β, which reduces the degree of SAP-ALl.

关 键 词：肠内免疫微生态营养 重症急性胰腺炎 急性肺损伤 Toll-样受体4 核转录因子-ΚB 大鼠 

分 类 号：R657.51[医药卫生—外科学]