低渗肠内喂养减轻坏死性小肠结肠炎肠上皮损伤及其机制研究  

Protective effects and mechanism of hypotonic enteral feeding on reduction of intestinal injury in necrotizing enterocolitis

作　　者：余梦楠 刘钢[1] 黄柳明 封志纯 Yu Mengnan;Liu Gang;Huang Liuming;Feng Zhichun(Senior Department of Pediatrics,the Seventh Medical Center of PLA General Hospital,National Engineering Laboratory for Birth defects prevention and control of key technology,Beijing Key Laboratory of Pediatric Organ Failure,Beijing 100070,China)

机构地区：[1]解放军总医院第七医学中心,出生缺陷防控关键技术国家工程实验室,儿童器官功能衰竭北京市重点实验室,北京100700

出　　处：《首都食品与医药》2024年第7期12-15,共4页Capital Food Medicine

基　　金：军委后勤保障部卫生局军队计划生育专项(21JSZ18)。

摘　　要：目的研究低渗肠内喂养减轻新生大鼠坏死性小肠结肠炎(NEC)肠道上皮损伤的作用,为新防治措施提供理论基础。方法为新生12小时内SD大鼠编号,交替随机将其分为对照组、标准配方奶喂养组和低渗配方奶喂养组,每组20只。通过人工灌胃、脂多糖胃注(4mg/kg/d)及低氧刺激复制NEC大鼠模型。标准及低渗配方奶渗透压分别为256mOsm/kg和128mOsm/kg。48小时后活杀取材回肠。采用苏木精-伊红染色、电镜等技术研究肠内喂养渗透压对大鼠肠道上皮的影响;采用蛋白质免疫印迹法研究渗透压对肠道紧密连接蛋白表达的影响。结果与对照组相比,标准组及低渗组大鼠体重明显降低,差异有统计学意义(P<0.05)。标准组大鼠回肠可见肠管扩张、弹性差、肠壁淤血及积气,HE染色见末端回肠绒毛脱落、缩短,固有层及肌层间分离等NEC样改变。与标准组相比,低渗组大鼠一般状况较好,肠上皮绒毛较长,肠上皮损伤程度较低;电镜下显示上皮细胞微绒毛受损较轻、紧密连接增长程度更小。回肠紧密连接闭锁小带蛋白-1、闭合蛋白的表达为对照组>低渗组>标准组,有统计学差异(P<0.05)。结论NEC病变可出现肠绒毛脱落、缩短、紧密连接长度增加,紧密连接蛋白表达降低。低渗肠内喂养能减轻肠上皮损伤,可能机制为减轻肠道紧密连接蛋白的破坏。Objective To explore the effect of hypotonic enteral feeding on intestinal injury and possible mechanism.Methods Newborn SD rats were included and subscribed into control group(dam fed),standard feeding group and hypotonic feeding group.NEC model was built by formula feeding,hypoxia stress and gastric injection of lipopolysaccharide.Ileum samples were obtained after 48 hours for evaluation.Intestinal morphology were assessed by hematoxylin-eosin staining and electron microscopic analysis.The expression of tight junction proteins were analyzed by western blot.Results The ileum in the standard group showed classical NEC manifestations.The hypotonic feeding group showed more slight injury and shorter TJ elongation. The expression of zonula occluden-1 and occludin werehigher in the hypotonic feeding group than the standard feeding group. Conclusion Hypotonic feeding may remit intestinal damage inNEC by reducing breakdown of TJ proteins.

关 键 词：坏死性小肠结肠炎 渗透压 肠损伤 大鼠 

分 类 号：R574.62[医药卫生—消化系统]