不同途径补充谷氨酰胺对大鼠肠粘膜和通透性的影响  

Effect of Glutamine on Gut Mucous and Permeability in Different Nutritional Supplementation Fashion in Rats

作　　者：何桂珍[1] 杨乃发[1] 刘跃武[1] 舒红[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院外科,北京100730

出　　处：《中国临床营养杂志》2004年第1期13-17,共5页Chinese Journal of Clinical Nutrition

摘　　要：目的比较大鼠手术化疗时,普通肠外、肠内营养与补充谷氨酰胺的肠外、肠内营养对肠道功能的影响。方法雄性Wistar大鼠60只,随机分为6组n=10:Chow1组,普通饲料加中心静脉插管;PN组,普通肠外营养;PN+G组,肠外营养加谷氨酰胺;Chow2组,普通饲料加胃造瘘;EN组,普通肠内营养;EN+G组,肠内营养加谷氨酰胺。Chow组给普通饲料,肠外和肠内营养组所给营养液均为等氮2.5gN·kg-1·d-1、等热卡1046kJ·kg-1·d-1(250kcal·kg-1·d-1),氮热卡比值1∶100。4组营养支持大鼠在术后第4天,按75mg·kg-1体重腹腔注射5-Fu。结果1体重:术后第8天时,以PN组下降最显著-14.8±7.6gP<0.05EN组其次-6.6±2.2gP<0.05PN+G组略有下降-1.1±0.2g,但无统计学差异EN+G组体重则有所增加2.7±4.2g。2谷氨酰胺浓度:与Chow组比较,PN组和EN组血浆和肌肉的谷氨酰胺浓度显著下降,而PN+G组和EN+G组谷氨酰胺浓度增高。3细菌移位:PN组和EN组细菌移位阳性率分别为80%和70%P<0.05PN+G组、EN+G组和Chow组分别为30%、30%和20%,3组间比较无显著差异。4肠道粘膜通透性:与手术后化疗前比较,PN组和EN组的通透性增加P<0.05,而PN+G组和EN+G组的通透性变化不大,与Chow组比较无显著性差异。5肠粘膜形态:术后第8天时,PN组和EN组空肠和结肠粘膜厚度和绒毛高度显著低?Objective To evaluate the effects of common and glutamine-supplemented parenteral and enteral nutrition on gut function during postoperative chemotherapy. Methods Sixty wistar rats were randomly divided into six groups(n = 10): group 1, standard chow with central catheter inserted (Chow 1); group 2, common parenteral nutrition(PN); group 3, parenteral nutrition supplemented with glutamine (2 g/100 ml) (PN+G); group 4, standard chow with gastrostomy(Chow 2); group 5, standard enteral nutrition(EN); group 6, standard enteral nutrition with glutamine(2 g/100 ml)(EN+G). All rats received isonitrogenous(2.5 g N·kg-1·d-1)and isocaloric infusions(250 kcal·kg-1·d-1). 5-Fu was injected intraperitoneally on POD+4 in groups 2,3,5 and 6. The rats were weighted before the operation and on POD+8 respectively. The glutamine levels in plasma and muscle, bacterial translocation of mesenteric lymph nodes(MLNs),and intestinal permeability were measured on post-operative day 8. Results (1)Body weight loss of EN group was less significant than PN group,(-6.6 ± 2.2)g vs(-14.8 ± 7.6)g; whereas EN+G group gained body weight(2.7 ± 4.2)g.(2)Glutamine levels in plasma and muscle in PN and EN groups declined markedly when compared with chow group, but increased in PN+G and EN+G groups.(3)Bacterial translocation to MLNs revealed that the positive percentage in PN and EN groups was 80% and 70% respectively(P < 0.05), and those in PN+G, EN+G, and chow groups were 30%, 30%, and 20%, respectively.(4)The intestinal permeability(L/M)was increased in PN and EN groups(P < 0.05).(5)Morphology of ileum and jejunum were better in PN+G, EN+G, and Chow groups than PN and EN groups. Conclusions Glutamine could attenuate the body weight loss and bowel mucoused atrophy, and preserve the gut barrier function. Enteral glutamine supplementation showed an trend of better effect compared with parenteral supplementation.

关 键 词：谷氨酰胺 大鼠 肠粘膜通透性 肠道功能 营养支持 肠道细菌移位 

分 类 号：R459.3[医药卫生—治疗学]