不同肠内营养液与生长激素联合应用对烫伤大鼠炎性反应的影响

目的 了解标准肠内营养(EN)、肠内免疫营养(EIN)液与重组人生长激素(rhGH)联合应用对烫伤大鼠炎性反应的影响. 方法 将128只SD大鼠按随机数字表法分为EN、EIN、EN+rhGH、EIN+rhGH组,每组32只.将大鼠制成总面积30%TBSA的Ⅲ度烫伤模型,分别于伤后1、4、7、10 d抽取各组大鼠静脉血,检测血清内毒素、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平;切取大鼠肝组织检测其CD14 mRNA、TNF-α mRNA的表达.另取8只SD大鼠作为对照组,检测上述指标. 结果 伤后各组各时相点大鼠血清内毒素、IL-6、TNF-α水平以及肝组织中的CD14 mRNA、TNF-α mRNA表达均高于对照组(P＜0.01).伤后4、7、10 d,EIN组和EN+rhGH组血清内毒素、IL-6、TNF-α水平以及肝组织CD14 mRNA、TNF-α mRNA表达均低于EN组(P＜0.05或P＜0.01);伤后10 d,EIN+rhGH组血清内毒素(0.37±0.07)EU/mL]、IL-6(289±49)ng/L]、TNF-d(1.87±0.32)μg/L]水平以及肝组织CD14 mRNA(0.39±0.05)、TNF-α mRNA(0.47±0.03)表达均低于EIN组(0.48±0.08)EU/mL、(364±53)ng/L、(2.50±0.48)μg/L、0.67±0.06、0.66±0.05,P＜0.05或P＜0.01]. 结论 EN、EIN液与rhGH联合应用可减轻大鼠烫伤后的炎性反应,且rhGH具有明显的协同作用.

Effects of different entered nutrition formulae combined with recombinant human growth hormone on inflammatory response in rats with scald injury

Objective To investigate the effects of enteral immunonutrition or enteral nutrition combined with recombinant human growth hormone(rhGH)on inflammatory response in rats with severe scald.Methods One hundred and twenty-eight SD rats were inflicted with 30%TBSA full-thickness scald.then they were divided into enteral nutrition(EN),enteral immunonutrition(EIN),EN combined with rhGH(EN+rhGH)and EIN combined with rhGH(EIN+rhGH)groups according to random number table.The serum levels of endotoxin.IL-6 and TNF- as well as the expression of CD14 and TNF- mRNA in liver were determined on the 1,4,7,10 post scald day(PSD).Eight normaJ SD rats served as control,and above indices were also examined in this group(C group). Results The levels of endotoxin,IL-6 and TNF=α as well as the expression of CD14mRNA,TNF.otmRNA in EN,EIN,EN+rhGH,EIN+rhGH groups were remarkably　higher than those of C group at each time point.The levels of endotoxin.IL-6 and TNF-α as well as the expression of CD14 mRNA.TNF-α mRNA in EIN and EN+rhGH groups were lowered significantly on 4.7 and 10 PSD compared with those of EN group(P＜0.05 orP＜0.01).The leve]s of endotoxin(0.37±0.07 EU/mL),IL-6(289±49 ng/L)and TNF-α(1.87±0.32μg/L)as well as the expression of CD14 mRNA (0.39±0.05),TNF-αmRNA(0.47±0.03)in EIN+rhGH group were also obviously lower than those (0.48±0.08)EU/mL,(364±53)ng/L,(2.50±0.48) μg/L,0.67±0.06,0.66±0.05,P＜0.05 or P＜0.01,respectively]in EIN group on 10 PSD(P＜0.05 or P＜0.01).Conclusion Enteral immunonutrition combined with rhGH can ameliorate inflammatory response.in which rhGH has a collaborative effect.