肠内免疫微生态营养支持对急性胰腺炎大鼠炎症反应的作用研究  

Enteral immune-microecological nutrition support suppresses inflammatory response in rats with acute pancreatitis

作　　者：秦学良[1] 崔晓鹏 戴鹏[1] 闫峻 Qin Xueliang;Cui Xiaopeng;Dai Peng;Yan Jun(Department of Hepatobiliary and Pancreatic Surgery,Shanxi Provincial People's Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院肝胆胰外科,山西太原030012

出　　处：《中华生物医学工程杂志》2021年第5期483-488,共6页Chinese Journal of Biomedical Engineering

摘　　要：目的分析肠内免疫微生态营养(EIN)支持对急性胰腺炎大鼠炎症反应的作用研究及其作用机制。方法32只SD雄性大鼠随机分为对照组、模型组、肠内营养(EN)组和EIN组;模型组、EN组和EIN组构建急性胰腺炎大鼠模型;对照组、模型组不予干预,EN组和EIN组分别采用EN方案和EIN方案干预;干预结束后摘取胰腺,行HE染色分析病理特征;检测血中淀粉酶(AMY)、钙(Ca^(2+))、胰脂肪酶(LPS)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)及白细胞介素18(IL-18)水平;采用PCR法和免疫印迹法检测组织中Toll样受体4(TLR4)、髓样分化因子88(MyD88)及β-actin的mRNA和蛋白水平。结果EIN组胰腺小叶结构已破坏,局部见紫红色坏死灶,间质充血水肿,坏死区可见少量炎症细胞浸润;干预后对照组、模型组、EN组和EIN组AMY、LPS、Ca^(2+)、TNF-α、IL-1β及IL-18水平差异有统计学意义,其中模型组Ca^(2+)水平最低,EIN组明显高于模型组和EN组,且差异有统计学意义(P<0.05);对照组、模型组、EN组和EIN组TLR4及MyD88 mRNA和蛋白水平差异有统计学意义,其中模型组最高,EIN组明显低于模型组和EN组,且差异有统计学意义(P<0.05)。结论EIN营养支持可通过Toll样受体4-髓样分化因子88途径有效抑制急性胰腺炎大鼠体内炎症反应,降低炎症因子表达水平。Objective To investigate the effect of enteral immune-microecological nutrition(EIN)nutritional support on inflammatory response in rats with acute pancreatitis and its mechanism.Methods Thirty-two male Sprague Dawley rats were randomly divided into the control group,model group,enteral nutrition(EN)group and EIN group.The model of acute pancreatitis was established in the model group,EN group and EIN group.The control group and model group were not intervened,while the EN group and EIN group were intervened with EN and EIN protocols,respectively.After the intervention,the rats were harvested for pancreatic glands which were then analyzed for pathological characteristics by HE staining.The blood levels of amylase(AMY),pancrelipase(LPS),calcium(Ca^(2+)),tumor necrosis factor(TNF-α)and Interleukin 1β(IL-1β)were measured.The mRNA and protein levels of Toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88)andβ-actin were examined by PCR and Western blotting.Results In the EIN group,the pancreatic lobule showed destructed structure uder microscopy,with purplish red necrotic foci,interstitial hyperemia and edema,and a small amount of inflammatory cells infiltration in the necrotic area.After intervention,there were significant differences in AMY,LPS,Ca^(2+),TNF-α,and IL-1βacross the control group,model group,EN group and EIN group.Among them,the Ca^(2+)level was lowest in the model group,and was significantly higher in the EIN group compared with the model group and the EN group(P<0.05).There were also significant differences in TLR4 and MyD88 mRNA and protein expression across the control group,model group,EN group and EIN group.These expression levels were highest in the model group,and was significantly lower in the EIN group compared with the model group and EN group(P<0.05).Conclusion EIN nutritional support can effectively inhibit the inflammatory response in rats with acute pancreatitis via the TLR4/MyD88 pathway and thereby reduce the expression of inflammatory factors.

关 键 词：肠内免疫微生态营养 TOLL样受体4 髓样分化因子88 急性胰腺炎 炎症反应 

分 类 号：R576[医药卫生—消化系统]