力肽及精氨酸在大鼠移植肠缺血再灌注损伤治疗中的作用

目的：探讨L－精氨酸（L-Arginine,L-Arg)和力肽在大鼠小肠移植（small bowel transplantation,SBT)缺血再灌注损伤中的治疗作用和协同效应。方法：将64只大鼠随机分为4组，对照组（n=16)行虚拟手术，给予普通饲料喂养；sTPN组（n=16)行同系小肠移植（syngeneic SBT)，接受力肽强化的全胃肠外营养;dTPN组（n=16)行同系小肠移植，接受力肽强化的全胃肠外营养（total parenteral nutrition,TPN);aTPN组（n=16)行小肠移植，给予加用L－Arg和力肽的肠外营养。各组于术后20min和术后8d(POD8）取材。结果：小肠移植术后20min，移植肠中度缺血再灌注损伤表现，移植肠粘膜一氧化氮（nitric oxid,NO)水平降低，丙二醛（malondialdehyde,MDA)含量升高，术后8d,aTPN组移植肠粘膜NO水平高于对照组及dTP组（P＜0．05，P＜0．01），dTPN组及aTPN组移植肠粘膜谷氨酰胺（glutamine,Gln)含量均高于sTPN组（P＜0．01，P＜0．01）；aTPN组较显著；dTPN组及aTPN组移植肠的绒毛高度、粘膜厚度均明显大于sTPN组。结论；大鼠在接受同系异体小肠移植术后，力肽强化的肠外营养液可促进移植小肠粘膜结构的修复，L－Arg可增强力肽对移植肠粘膜修复的作用。

Effects of dipeptiven and L-Arg in treatment of rat small bowel ischemia and reperfusion injure after transplantation

AIM To investigate the theraputic and synergetic effects of L Arginine and Alanine glutamine dipeptiven on rat grafted intestine in ischemia/reperfusion injure. METHODS 64 SD rats were randomly divided into 4 groups. The control group ( n =16) conducted fictitious operation and fed with common forage; sTPN group ( n =16) conducted syngeneic SBT and fed with traditional total parenteral nutrition (TPN); dTPN group ( n =16) were fed with Alanine glutamine dipeptiven intensified TPN after syngeneic SBT; aTPN group ( n =16) were fed with L Arg and Dipeptiven intensified TPN after syngeneic SBT. Samples were taken 20 minutes and 8 days after performance of transplantation. RESULTS 20 minutes after operation, transplanted intestinal mucosa displayed moderate ischemia/reperfusion injure with increased nitric oxide (NO) and decreased MDA level. In day 8 post operation, the NO level in grafts of aTPN group was higher than the control ( P <0.05) and dTPN group ( P < 0.01), and Gln content in grafts mucosa was higher in dTPN group and aTPN group than in sTPN group ( P<0.01, P <0.01), and it is significant in aTPN group. The villous height, mucosal thickness in dTPN group and aTPN group were all greater than that of sTPN group. CONCLUSION Alanine glutamine dipeptiven intensified TPN can Facilitate integrity of graft's mucosa structure while L Arg can improve the effect during rat syngeneic SBT.