表皮生长因子、谷氨酰胺强化的全胃肠外营养对肠屏障功能和肠细菌移位的影响

目的探讨表皮生长因子(epidermalgrowthfactor,EGF)、谷氨酰胺(glutamine,GLN)对全胃肠外营养(totalparenteralnutrition,TPN)并发症的防治作用及机制。方法将大白鼠分为4组A(正常喂养组)、B(标准胃肠外营养STPN)、C(TPN+GLN)、D(TPN+EGF+GLN)，采用大白鼠TPN模型，一周后取大鼠近端空肠组织切片行光镜和电镜观察，结合图像分析；无菌采取肠系膜淋巴结(mesenterlymphonodus,MLN)并称重和抽取腹腔静脉血作细菌培养(需氧培养)。结果B组肠黏膜萎缩，MLN细菌培养阳性率62.5%。C组较B组肠黏膜萎缩减轻，黏膜DNA、RNA含量和浆细胞数目增加，MLN细菌培养阳性率37.5%，肠细菌移位率下降。而D组上述各指数与正常鼠A组无显著差异。4组动物血培养均为阴性。结论EGF和GLN联合应用能有效地保护肠屏障功能和防止肠细菌移位

Effect of Epidermal Growth Factor and Glutamine-Supplemented Toal Parenteral Nutrition on Gut Barrier and Bacterial Translocation

Purpose To detect the prevention of EGF and GLN on the side effect of TPN. Methods We randomized SD rats into four groups:group A (control),B(STPN),C(TPN GLN),D(TPN GLN EGF).All rats were maintained on their respective diets for 8 days,at which time they were killed and the proximal jejunum was incised for biopsy,the MLN and celiac vein blood were collected for bacterial culture(aerobic culture). Results Group B rat mucosal cell atrophied,DNA and RNA content and plasma cell decreased,the positive rat of MLN bacterial culture was 62.5%.Atrophy in group C alleviated and bacterial translocation rate declined(37.5%).Group D was similar with group A. Conclusions GLN combined with EGF is more effective in protecting gut barrier function and preventing bacterial translocation than GLN alone.