摘要
目的研究肠道缺血再灌注损伤时肠淋巴干结扎和ω-3多不饱和脂肪酸（ω-PUFA）对肠道和远隔组织的影响。方法将40只SD大鼠胃造瘘后随机分为假手术组、肠内营养（EN）组、EN＋淋巴千结扎（EN＋L）组、ω-PUFA组和ω—PUFA＋L组5组，每组8只。营养干预7d后，用动脉夹夹闭肠系膜上动脉60min，结扎组同时进行肠淋巴干结扎，假手术组只开腹。术后继续原营养干预3d后，分别测定肠道通透性、肠黏膜形态、细菌培养和血中细胞因子。结果缺血再灌注3d后，EN组和EN＋L组大鼠体重较造瘘前明显下降（P〈0．05），EN＋L组大鼠体重明显低于ω-PUFA组和ω-PUFA＋L组（P〈0．05）。缺血再灌注后第1天，各组大鼠的L／M值均显著增加（P〈0．05或P〈0．01），缺血再灌注后第3天，EN＋L组、ω-PUFA组和ω-PUFA＋L组大鼠的L／M值均明显低于缺血再灌注后第1天（P〈0．05），EN组和EN＋L组大鼠的L／M值明显高于ω-PUFA＋L组（P〈0．05）；ω—PUFA组和ω-PUFA＋L组大鼠的空肠黏膜厚度及绒毛高度均明显高于假手术组、EN组和EN＋L组（P〈0．05或P〈0．01），其回肠黏膜厚度及绒毛高度也均明显高于EN组（P均〈0．05）；ω-PUFA＋L组大鼠的血清内毒素和肿瘤坏死因子-α水平明显低于EN组（P〈0．05），白细胞介素（IL）-6水平明显低于ω-PUFA组（P〈0．05），IL-1β水平明显低于其余各组（P〈0．05）；EN组大鼠的肺细胞凋亡指数明显高于其余4组（P〈0．05），其诱导型一氧化氮合酶和髓过氧化物酶浓度明显高于ω-PUFA＋L组（P〈0．05），EN＋L组大鼠的诱导型一氧化氮合酶浓度也明显高于ω-PUFA＋L组（P〈0．05）。结论缺血60min可引起大鼠肠道损伤、肠屏障功能障碍、通透性增加；再灌注72h后，肠道损伤部分恢复，通透性较缺血后降低，细菌内毒素仍存在移位，肺仍有凋亡细胞。肠淋巴管结扎可弱化�
Objective To investigate the effect of intestinal lymphatic duct ligation and ω-3 polyun- saturated fatty acids on intestinal and distant organ in intestinal ischemia-reperfusion injury. Methods Totally 40 Sprague-Dawley （SD） male rats （SPF grade） after gastrostomy were equally randomized into sham group （ Sham）, enteral nutrition （ EN ） group, enteral nutrition and lymphatic duct ligation （ EN ＋ L） group, ω-3 polyunsaturated fatty acids （ω-3PUFA） group, and ω-3PUFA and lymphatic duct ligation （ω-3PUFA ＋ L） group. After 7 days of nutritional intervention, rats were subjected to 60 minutes of intestinal ischemia, ischemia plus mesenretie lymph duct ligation, or sham procedures. After 3 days of continuous nutrition intervention using the original nutrient, lymph nodes, lung, intestine, liver, and blood specimens were harvested. Intestinal permeability and morphology, results of bacterial cultures, and serum cytokines were observed or detected. Result After 3 days of intestinal ischemia-repeffusion （I/R） , the body weights of rats in EN group significandy decreased when compared with the pre-I/R levels （ P 〈 0.05 ）, while the body weights of rats in EN ＋ L group were significantly lower than those in to-PUFA group and ω-PUFA ＋ L group （P 〈 0. 05 ）. After one day of intestinal ischemia-repeffusion （ I/R）, the IMM significantly increased in each group （P 〈 0. 05 or P 〈 0.01 ）. After 3 days of intestinal ischemia- reperfusion （ I/R）, the L/M were significantly lower than the level one day after ischemia- repeffusion in EN ＋ L group, ω-PUFA group, and ω-PUFA ＋ L group （ P 〈0.05 ） . The L/M in EN group and EN ＋ L group were significantly higher than that in ω-PUFA ＋ L group （ P 〈 0.05 ）. The mucosa thickness and villus height of jejunum in ω-PUFA group and to-PUFA ＋ L group were significantly higher than those in Sham group, EN group, and EN ＋ L group （P 〈 0.01 or P 〈 0, 05 ）. The mucosa thickness and villus
出处
《中华临床营养杂志》
CAS
2010年第2期95-100,共6页
Chinese Journal of Clinical Nutrition
基金
基金项目：国家自然科学基金（304717（37）
关键词
肠道缺血再灌注
淋巴干结扎
肠内营养
Ω-3多不饱和脂肪酸
Intestinal ischemia/reperfusion
Mesenteric lymph duct ligation
Enteral nutrition
ω-3 poly-unsaturated fatty acids
