摘要
目的评价早期应用益生菌型肠内营养对急性坏死性胰腺炎（ANP）大鼠炎症反应和免疫功能的影响。方法100只SD大鼠按数字表法随机分为对照组、ANP组、传统肠内营养（瑞素）组、益生菌组和瑞素＋益生菌（联合）组，每组20只。采用胰胆管逆行注射5％牛磺胆酸钠1．5ml／kg体重方法制备ANP模型。另经胃留置空肠营养管。各组于术后12、24、48、72h分批处死大鼠，取血检测血清巨噬细胞移动抑制因子（MIF）、淀粉酶水平及T细胞亚群，取胰腺组织常规病理检查，并采用免疫组化法检测胰腺组织MIF的表达。结果制模后各组MIF、淀粉酶水平较对照组明显升高。制模后72h，瑞素组、益生菌组和联合组血MIF水平分别为（117．59±1．86）ug/L、（108．39±1．99）ug/L和（95．33±1．96）ug／L，血淀粉酶水平分别为（2799±161）U／L、（2482±140）U／L和（2146±572）U／L，益生菌组和联合组均较瑞素组显著下降（P〈0．05），联合组又较益生菌组显著下降（P〈0．05）。制模后各组CD3^＋、CD4^＋细胞和CD4^＋／CD8^＋值较对照组下降。制模后72h，瑞素组、益生菌组和联合组的CD4^＋／CD8^＋值分别为0．93±0．12、1．31±0．13、1．51±0．10，益生菌组和联合组均较瑞素组显著回升（P〈0．05），联合组又较益生菌组显著回升（P〈0．05）。对照组、ANP组、瑞素组、益生菌组和联合组MIF阳性表达率分别为45％、96％、95％、65％和60％，益生菌组和联合组较ANP组和瑞素组显著降低（P〈0．05）。制模后72h联合组大鼠胰腺病理损伤较瑞素组和益生菌组轻。结论益生菌型肠内营养能有效调节ANP大鼠炎症介质和细胞因子水平，增强机体免疫功能。
Objectives To evaluate the effect of probiotics enteral nutrition therapy on the inflammatory reaction and immune function in acute necrotizing pancreatitis （ANP） in rats. Methods 100 SD rats were divided randomly into control group （ C group, n = 20 ） , ANP group, enteral nutrition group （ EN group, n = 20）, probiotics group （P group, n = 20） and enteral nutrition plus probiotics group （PEN group, n = 20）. ANP were induced by retrograde injection of 5% sodium taurocholate （1.5 ml/kg） into the biliary and pancreatic duct. The nasojejunal tube was placed via gastric route. The rats were sacrificed at 12 h, 24 h, 48 h and 72 h after ANP modeling. Serum MIF and amylase levels, as well as CD3^＋ , CD4^ ＋ , CD8^ ＋ were measured and MIF was determined by immunohistochemistry and the histopathological changes in pancreatic tissue were observed. Results Serum MIF and amylase levels were all increased when compared with that in C group . 72 h after ANP modeling, serum MIF levels in EN, P, PEN groups were （117.59 ± 1.86） ug/L,（ 108.39 ± 1.99） ug/L and （95.33 ± 1.96） ug/L, respectively; serum amylase levels were （2799 ± 161 ） U/L, （2482 ± 140）U/L and （2146 ± 572）U/L, respectively; the values in P and PEN groups were significantly lower than that of EN group （ P 〈 0.05 ）, the values in PEN groups were significantly lower than that of P group （P 〈0.05）. After ANP induction, CD4 ^＋/CD8^＋ values in EN, P and PEN groups were 0.93 ±0.12, 1.31 ± 0. 13, 1.51 ± 0.10, respectively; the values in P and PEN groups were significantly higher than that of EN group （ P 〈 0.05 ）, the values in PEN groups were significantly higher than that of P group （ P 〈 0.05 ）. MIF positive rates in C, ANP, EN, P and PEN group were 45% , 96% , 95% , 65% and 60% ,respectively; the values in P and PEN groups were significantly lower than those of ANP and EN group （ P 〈 0.05 ）. At 72 h, the damage of pancreatic tissue was more severe in EN and P groups than that in PEN group. Conclusions Probiotics enteral nutrition could effectively regulate inflammation mediator and cytokines in rats with ANP, and enhance immune function.
出处
《中华胰腺病杂志》
CAS
2010年第1期40-43,共4页
Chinese Journal of Pancreatology
基金
基金项目：2008年安徽省临床医学重点学科新技术引进项目（2008N017）
关键词
胰腺炎
急性坏死性
肠道营养
益生菌
Pancreatitis, acute necrotizing
Enteral nutrition
Probiotics
作者简介
通信作者：汤志刚，Email：tougao_100@163．com
