围手术期肠内免疫营养对肝硬化肝切除鼠免疫功能的影响

目的：观察围手术期使用肠内免疫营养剂对肝硬化肝切除大鼠免疫功能的调理作用。方法：48只肝硬化大鼠随机分为两组,A组为标准肠内营养组,B组为肠内免疫营养组,依标本采集时间不同,各组再分为4个亚组。大鼠用肠内营养剂喂养8d后行68%肝切除术,术后再用肠内营养剂喂养至取标本时间。分别于术前和术后1、4、8d取相应亚组大鼠全血,检测T细胞亚群分类、IgG和IL-6。结果：两组大鼠术后均有免疫功能降低和急性炎症反应的发生,但B组的程度明显低于A组。B组术后1dCD3、CD4、CD4/CD8和IgG,术后4dCD4、CD4/CD8和IgG,术后8dCD4/CD8和IgG均显著高于A组（P〈0.05）;B组术后1、4dIL-6显著低于A组（P〈0.05）。结论：围手术期肠内免疫营养支持与标准肠内营养相比,能减轻肝硬化肝切除大鼠术后的免疫抑制,增强术后的免疫功能,下调术后过度的急性炎症反应。

Effects of perioperative enteral immunonutrition on immune function in rats with hepatic cirrhosis undergoing partial hepatectomy

ObjectiveTo observe the effects of perioperative enteral immunonutrition on immune function in cirrhotic rats with partial hepatectomy.Methods Forty-eight cirrhotic rats were randomized to receive standard enteral nutrients(group A),or enteral immunonutrition(group B).Each group was then subdivided into four groups according to the acquisition time of blood samples.Nutrient administration was started from 8 days before partial hepatectomy and continued to 1 to 8 days after operation.Blood T lymphocyte subsets,and serum levels of IgG and IL-6 were determined before hepatectomy and on postoperative days(PODs) 1,4,and 8.Results Postoperative immunosuppression and acute inflammatory responses occurred in two groups,but their levels in group B were markedly lower.The levels of CD3,CD4,CD4/CD8 ratio,and IgG on POD 1,all of those except CD3 on POD 4,and CD4/CD8 ratio and IgG on POD 8 in group B were superior to those in group A(P < 0.05).IL-6 levels were significantly lower in group B than that in group A on PODs 1 and 4(P < 0.05).Conclusion Compared with standard enteral nutrition,perioperative enteral immunonutrition can alleviate immunosuppression,enhance immune function,and inhibit inflammatory response after hepatectomy for cirrhotic rats.