摘要
目的研究早期肠道营养对血清肿瘤坏死因子α(TNF-α)和氧自由基水平的影响以及对机体的保护作用,为临床烧伤患者早期肠内营养支持治疗提供依据。方法建立Wistar大鼠重度烧伤模型。随机将烧伤大鼠分为禁食组(n=10)和早期肠内营养组(早期营养组n=10),另设未烧伤的对照组(n=10)。禁食组和早期营养组于烧伤后48 h内分别给予腹腔注射平衡液和胃灌注营养制剂,均为30 ml/(kg.次),每6 h一次;其后自由进食至实验后第7天。统计各组死亡率;检测各组大鼠6、12、24、48 h及第7天时TNF-α及氧自由基;电镜下观察创面成纤维细胞;苏木精-伊红染色观察肝细胞变性情况。结果禁食组、早期营养组和对照组的死亡率分别为80%、30%、0。与对照组相比,禁食组大鼠血清TNF-α和丙二醛(MDA)水平明显升高,而超氧化物歧化酶(SOD)水平明显下降(P<0.05);与禁食组比较,早期营养组TNF-α和MDA水平降低,SOD水平升高。早期营养组创面成纤维细胞超微结构受损程度低于禁食组,并发现凋亡的成纤维细胞。早期营养组大鼠肝脏脂肪变性程度较禁食组大鼠为轻。结论早期肠道营养能够在整体水平降低TNF-α及氧自由基的表达,有利于局部创面愈合和减轻内脏损伤。
Objective To investigate the effect of enteral feeding at early stage on the expression of TNF -α and oxygen free radical （OFR） and the protective effects on the organism, so as to provide the experimental basis of clinical therapy of enteral feeding in patients with severe burns. Methods The severe burn model was established with Wistar rats. Burned Wistar rats were randomly derided into fasting group （n = 10） and early enteral nutrition group （n = 10） to compare with the control group （ n = 10 ）. The rats in the fasting group and early nutrition group were given intraperitoneal injection of balance liquid and gastric clysis of nourishment product respectively, 30 ml every 6 h within 48 h after burn injury. Subsequently, the rats were allowed access to food ad libitum until 7 th day and the mortalities of the three groups were calculated. The expression of blood TNF -α and OFR of the three groups at 6, 12, 24, 48, 72 h and on 7d were detected. The fibroblasts in the wound were observed under the electron microscope and the denaturalization of hepato- cytes was observed by H - E staining under the light microscope. Results The mortality of fasting group, early nutrition group and control group was 80% , 30% and 0, respectively. Compared with the control group, the level of TNF -α and malonaldehyde （MDA） obviously ascended, while the level of super oxide dismutase （SOD） obviously descended in the fasting group （P 〈 0.05 ）. Compared with the fasting group, the level of TNF -α and MDA descended, while SOD level obviously ascended in early nutrition group （ P 〈 0.05 ）. The ultrastructure of fibroblast cells in the wound of early enteral nutrition group was less severely damaged than in the fasting group, accompanied by visible apoptotic fibroblasts. The de- gree of hepatic steatosis in the early enteral nutrition group was lower than in the fasting group. Conclusion Early en- teral nourishment could reduce the expression of TNF -α and OFR on the whole, and help heal the local wounds relieve injuries to the viscera.
出处
《徐州医学院学报》
CAS
2009年第3期158-162,共5页
Acta Academiae Medicinae Xuzhou
关键词
烧伤
氧自由基
肿瘤坏死因子Α
肠内营养
burn
oxygen free radical
tumor necrosis factor -α
enteric nutrition
