肠内免疫营养联合重组人生长激素对烫伤大鼠的治疗作用

目的 研究肠内免疫营养联合重组人生长激素（rhGH）对烫伤大鼠营养代谢、免疫功能及炎性反应的影响及其机制。方法 64只SD大鼠制备30％总体表面积（TBSA）Ⅲ度烫伤模型，然后随机分为肠内免疫营养（EIN）组及EIN联合rhGH（EIN＋rhGH）组，两组给予等热量肠内营养液。分别于伤后1、4、7、10d（n=8）抽取静脉血，检测营养代谢、T淋巴细胞亚群、血清免疫球蛋白和有关炎性介质指标。另取8只大鼠检测上述各指标作为伤前对照值。结果 与EIN组比较，EIN＋rhGH组在伤后各时间点的血清总蛋白、自蛋白、转铁蛋白、CD3^＋、CD4^＋、CD4^＋／CD8^＋、IgG、IgM和IgA均有所升高，但差异均无显著性（P均〉0．05），CD8。有所降低，差异也无显著性（P均〉0．05）；与EIN组比较，EIN}rhGH组在伤后4、7、10d血清内毒素（LPS）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNFQ）明显降低（P〈0．05或P〈0．01）。结论 EIN联合rhGH可以改善烧伤后营养代谢和免疫功能，减少炎性反应，其作用要优于单纯肠内免疫营养。

Experiment study of enteral immunonutrition combined with recombinant human growth hormone in treatment of severe scald in rats

OBJECTIVE: To investigate the effects of enteral immunonutrition (EIN) combined with recombinant human growth hormone (rhGH) on nutrition metabolism, immunological function and inflammatory response in rats with severe scald. METHODS: Sixty-four SD rats subjected to 30% total body surface area (TBSA) III degree scalds were randomly divided into EIN and EIN combined with recombinant human growth hormone (EIN+rhGH) groups. Animals of both groups were fed isocaloric enteral nutrition. Nutrition metabolism, T lymphocyte subsets, serum levels of immunoglobulins and inflammatory mediators were determined on the 1, 4, 7 and 10 postinjury day (n=8). Another 8 rats served as controls, and the above-mentioned parameters were also determined. RESULTS: Total protein (TP), albumin (Alb), tiansferrin protein (TFP), CD3(+), CD4(+), CD4(+)/CD8(+), IgG, IgM and IgA in group EIN+rhGH were slightly higher than those of group EIN (all P>0.05) at all time points after the injury, while CD8(+) slightly lowered (P>0.05). Serum levels of lipopolysaccharide (LPS), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) plummeted significantly (P<0.05 or P<0.01)on 4th, 7th and 10th postinjury day compared with group EIN. CONCLUSION: Our findings indicate that EIN combined with rhGH is superior to EIN alone in the early stage of severe scald in rats, not only ameliorate the disturbance in metabolism and immunological function, but also reduce inflammatory response.