谷氨酰胺对重症急性胰腺炎大鼠肠道损伤影响的实验研究

目的通过建立实验性重症急性胰腺炎大鼠模型，谷氨酰胺灌胃，以期寻求谷氨酰胺在重症急性胰腺炎时的肠道保护作用及其分子机制。方法雄性SD大鼠90只，随机分为三组：假手术组、SAP组、谷氨酰胺治疗组。检测血浆D-乳酸OD值；免疫组化技术分析小肠组织ICAM-1的表达和肠黏膜细胞凋亡（TUNEL法）情况。结果SAP组在术后24h、48h和72h各点血浆D-乳酸OD值均明显高于OP组，同时也高于谷氨酰胺治疗组。造模后24h、48h和72h，SAP组肠组织血管内皮细胞ICAM-1表达光密度值与OP组相比明显增高。与谷氨酰胺治疗组相比，SAP组的ICAM-1的表达则有所下降。肠黏膜组织在SAP组发生细胞凋亡的数目与OP组相比明显增加。而谷氨酰胺治疗组与SAP组比较，细胞凋亡数目则有所降低。结论重症急性胰腺炎时肠黏膜屏障功能的损伤受多种因素的调节，而谷氨酰胺作为肠道的能源物质，对重症急性胰腺炎时肠黏膜屏障功能的破坏具有明显的保护作用。

Effects of glutamine on intestinal damage of rats with severe acute pancreatitis

Objective To investigate the protective effects of glutamine on intestines in rats with experimental severe acute pancreatitis (SAP). Methods Ninety male adult SD rats were randomized into the sham-operated group, SAP group and glutamine-treated group. The plasma level of D-lactic acid was determined. The ICAM-1 expression in the intestines were determined with immunohis-tochemistry and the apoptosis of intestinal mucosal cells by TUNEL. Results In SAP group and glutamine-treated group, there were congestion, edema and point hemorrhage of the pancreas in the rats. The OD values of plasma D-lactic acid at 24, 48 and 72 h after establishment of the SAP model were higher in SAP group than in the other 2 groups. The OD values of expression of ICAM-1 in endothelial cells of the intestines at 24, 48 and 72 h after the establishment of SAP model were markedly higher in SAP group than in sham-operated group but lower than in glutamine-treated group. The number of apoptotic intestinal mucosal cells was remarkably higher in SAP group than in other 2 groups. Conclusions The damage of the gut mucosa barrier in SAP is influenced by manifold factors. Glutamine, as the energy substance of intestines, has protective effects on the intestines in SAP.