谷氨酰胺强化的肠外营养对老年重症急性胰腺炎大鼠C-反应蛋白和体液免疫功能的影响

发布时间：2019-04-27 14:15

【摘要】：目的考察谷氨酰胺(Gln)强化的肠外营养对重症急性胰腺炎(SAP)老年大鼠C-反应蛋白(CRP)和体液免疫功能的影响。方法所有大鼠分5组:1对照组、2假手术组、3SAP组、4常规肠外营养组和5 Gln强化营养组,每组5只。1~3组颈内静脉给予400 ml·kg-1·d-1注射用生理盐水;4组建模24 h内,经颈内静脉以400 ml·kg-1·d-1匀速输入平衡液,建模24 h后,给予常规肠外营养液;5组在4组基础上按1.5 ml/kg加入L-丙氨酰-L-谷氨酰胺(LALG)注射液后立即输入,连续给药7 d。结果对照组、假手术组与Gln强化营养组无死亡,SAP组死亡2只,常规肠外营养组死亡1只。对照组和假手术组免疫功能无显著差异(P0.05);与假手术组比,SAP组Ig G、Ig A和Ig M均有不同程度的降低(P0.05);与SAP组比,常规肠外营养组和Gln强化营养组的Ig G、Ig A和Ig M均有不同程度的升高(P0.05);与常规肠外营养组比,Gln强化营养组的Ig G、Ig A和Ig M均有不同程度的升高(P0.05)。与对照组比,其余组别的血浆内毒素显著增高(P0.05);与SAP大鼠组比,常规肠外营养组和Gln强化营养组内毒素显著降低(P0.05);与常规肠外营养组比,Gln强化营养组内毒素显著降低(P0.05)。对照组与假手术组的胰腺组织间质水肿、炎细胞浸润和坏死评分较低,其余组别评分较高。与SAP组比,常规肠外营养组和Gln强化营养组胰腺组织间质水肿、炎细胞浸润和坏死评分均有不同程度的降低(P0.05);与常规肠外营养组比,Gln强化营养组胰腺组织间质水肿、炎细胞浸润和坏死评分较低(P0.05)。结论 Gln增强的肠外营养能显著改善SAP大鼠机体免疫、降低血浆内毒素,有利于细胞与器官功能的恢复,减轻病情的危重程度。
[Abstract]:Aim to investigate the effects of glutamine (Gln)-enhanced parenteral nutrition on C-reactive protein (CRP) and humoral immune function in elderly rats with severe acute pancreatitis (SAP). Methods all rats were divided into 5 groups: 1 control group, 2 sham operation group, 3SAP group, 4 routine parenteral nutrition group and 5 Gln fortified nutrition group, 5 rats in each group were given 400 ml kg- 1 路d-1 saline by intrajugular vein injection. 4within 24 hours of establishment of the model, the balance fluid was injected into the internal jugular vein at a constant rate of 400 ml kg- 1 路d-1. After 24 hours of modeling, the routine parenteral nutrition solution was given. On the basis of 4 groups, L-alanyl-L-glutamine (LALG) injection was added to group 1. 5 ml/kg and was immediately injected into the injection for 7 d. Results No death was found in the sham operation group and Gln fortified nutrition group, 2 died in the SAP group and 1 died in the routine parenteral nutrition group. There was no significant difference in immune function between the control group and the sham operation group (P0.05). Compared with the sham operation group, the Ig G, IgA and Ig M of the SAP group decreased to some extent (P0.05). Compared with the SAP group, the Ig G, IgA and Ig M of the conventional parenteral nutrition group and the Gln fortified nutrition group increased to some extent (P0.05). Compared with the conventional parenteral nutrition group, the levels of Ig G, IgA and Ig M in the Gln fortified nutrition group were significantly higher than those in the conventional parenteral nutrition group (P0.05). Compared with the control group, the plasma endotoxin levels in the other groups were significantly higher (P0.05), and those in the conventional parenteral nutrition group and the Gln fortified nutrition group were significantly lower than those in the SAP rats group (P0.05). Compared with the conventional parenteral nutrition group, the endotoxin level in Gln fortified nutrition group was significantly lower than that in the conventional parenteral nutrition group (P0.05). The scores of pancreatic interstitial edema, inflammatory cell infiltration and necrosis in the control group and sham operation group were lower than those in the other groups. Compared with SAP group, the interstitial edema, inflammatory cell infiltration and necrosis scores of pancreatic tissue in conventional parenteral nutrition group and Gln intensive nutrition group were decreased to different degrees (P0.05). Compared with the conventional parenteral nutrition group, the scores of interstitial edema, inflammatory cell infiltration and necrosis of pancreatic tissue in the Gln intensive nutrition group were lower than those in the conventional parenteral nutrition group (P0.05). Conclusion Gln-enhanced parenteral nutrition can significantly improve the immunity of SAP rats and decrease the plasma endotoxin, which is beneficial to the recovery of cell and organ function and alleviate the severity of the disease.
【作者单位】：绍兴市中心医院普外科;
【分类号】：R576

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