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时间:2019-05-26
《肠内生态免疫营养对猪重症急性胰腺炎模型免疫功能的影响》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、胃肠病学2008年第13卷第5期肠内生态免疫营养对猪重症急性胰腺炎模型免疫功能的影响田觅1邹晓平,宰陈磊2王莉,顾超2南京医科大学鼓楼临床医学院消化内科1(210008)南京大学医学院附属鼓楼医院消化内科2背景:重症急性胰腺炎(SAP)患者存在不同程度的免疫功能抑制,与疾病的发展和转归密切相关。研究显示肠内营养(EN)尤其是生态免疫营养(EIN)应用于SAP较肠外营养(PN)有显著优越性。目的:探讨肠内EIN对猪SAP模型免疫功能的影响。方法:制备猪SAP模型,18只实验猪随机分为PN组、肠内要素营养(E
2、EN)组和EIN组,分别予营养支持8d。动态检测各组血清、胰淀粉酶水平、T细胞亚群和血清IgG、IgA、IgM水平,观察胰腺组织病理学改变。结果:造模后各组血清、胰淀粉酶水平明显升高,CD3+、CD4+T细胞和CD47CD8+比值降低,血清IgG、IgA、IgM水平降低.予营养支持后上述指标均有所改善(除PN组血清IgG水平)。除血清淀粉酶和IgM水平,EIN对其余各指标的改善作用均较PN和EEN更为明显(P<0.05)。三组间胰腺组织病理学评分无明显差异。结论:早期肠内EIN增强猪SAP模型免疫功能的作
3、用优于PN和EEN,可明显提高治疗效果。关键词重症急性胰腺炎;生态免疫营养;肠道营养;胃肠外营养;免疫E舵ctofEnteralEcoimmunonutritiononImmuneFunctionofSevereAcutePancreatitisinPigModeITIANMi,ZOUXiaoping,CHENLei,WANGLi,GUChao.DepartmentofGastroenterology,TheDrumTowerClinicalMedicalCo№铲ofNanjingMedicalUnive
4、rsity,Nanjing(210008)Correspondenceto:ZOUXiaoping,Emaihzouxiaopin9795@hotmail.cornBackground:Inhibitionofimmunefunctioninsevereacutepancreatitis(SAP)hasclosecorrelationwiththeprogressandprognosisofthedisease.Ithasbeenreportedthatenteralnutrition(EN),espec
5、iallyecoimmunonutrition(EIN)issuperiortoparenteralnutrition(PN)inthetreatmentofSAP.Aims:ToinvestigatetheeffectofenteralEINontheimmunefunctionofSAPinpigmodel.Methods:Eighteenpigswererandomlydividedintothreegroups,PNgroup,elementalenteralnutrition(EEN)group
6、,andEINgroupafterinductionofSAP.Eachgroupwastreatedwithabovementionednutritionsupportsforeightdays,respectively.Theserumandpancreaticamylase,Tlymphocytesubsets,andserumIgG,IsAandIgMlevelsweredetermineddynamically,andthehistopathologicalchangesofpancreaswe
7、reexamined.Results:Serumandpancreaticamylaseincreased,andCD3+,CD4+TlymphocytesandCD4VCD8+ratio,aswellasserumIgG,IgAandIgMlevelsdecreasedafterSAPinduction.Whentreatedwithnutritionsupports,mostoftheindicesmentionedaboveimproved.TheeffectofEINWasbetterthanth
8、atofPNandEEN(P<0.05)exceptforserumamylaseandIgMlevels.ThehistopathologicalSCOreofpancreasWasnotsignificantlydifferentbetweenthesethreegroups.Conclusions:EarlyenteralEINissuperiortoPNandEENinenhancingimmunefunctionof
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