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目的探讨谷氨酰胺在全胃肠外营养(TPN)中对铜绿假单胞菌所致肺部感染大鼠的保护作用。方法SD大鼠40只,随机分为4组,A组大鼠向气管内注入生理盐水0·3ml。B组大鼠向气管内注入0·3ml的铜绿假单胞菌悬浮液,并使细菌直接进入肺内。C组大鼠静脉泵标准的不含N(2)L-丙氨酰-谷氨酰胺(商品名为力肽)的TPN溶液160ml/kg,5d;D组大鼠静脉泵含力肽的TPN溶液160ml/kg,5d;C、D组大鼠第6天向气管内注入0·3ml的铜绿假单胞菌悬浮液,并使细菌直接进入肺内。观察大鼠生命活动。注菌48h后取外周血计数白细胞;行支气管肺泡灌洗,取灌洗液,计数其中的白细胞,测其中的TNFα、IL-1、IL-10水平及总蛋白含量。取肺、肝、回肠小块组织,光镜下观察病理改变。结果(1)实验开始时4组大鼠体重无明显差别,第8天时B、C、D组大鼠体重较A组轻;C组死亡的鼠数多于D、B组。(2)C组大鼠外周血WBC计数、血清中TNFα、IL-1高于D组,而IL-10低于D组。C组大鼠支气管肺泡灌洗液中WBC计数、总蛋白含量、TNFα高于D组,而IL-10低于D组。(3)光镜下见C组大鼠肺、肝、回肠组织病理改变明显重于D、B组,A组基本正常。结论谷氨酰胺可保护TPN大鼠的胃肠道功能,提高肺部抗感染能力,并减轻由严重感染所致其他重要器官的损害。
Objective To investigate the protective effect of glutamine on total parenteral nutrition (TPN) in rats with pulmonary infection caused by Pseudomonas aeruginosa. Methods Forty Sprague-Dawley rats were randomly divided into four groups. Rats in group A were injected with 0.3 ml of saline into the trachea. Group B rats were intratracheally injected with 0.3 ml of P. aeruginosa suspension and the bacteria were allowed to enter the lungs directly. Rats in group C received intravenous infusion of standard TPN solution without N (2) L-alanyl-glutamine (trade name Peptide) at 160 ml / kg for 5 days. Group D rats received TPN Solution 160ml / kg, 5d; C, D group rats on the 6th day intratracheal infusion of 0.3 ml of Pseudomonas aeruginosa suspension, and the bacteria directly into the lungs. Observed the life activities of rats. Peripheral blood was counted for leukocyte counting after 48 hours of bacterial instillation. Bronchoalveolar lavage was performed, and the leukocytes were counted and the levels of TNFα, IL-1, IL-10 and total protein were measured. Take lung, liver, ileum small pieces of tissue, observe the pathological changes under light microscope. Results (1) There was no significant difference in body weight between the 4 groups at the beginning of the experiment. On the 8th day, the body weight of rats in groups B, C and D was lighter than that of group A; the number of rats died in group C was more than that of group D and group B. (2) WBC counts in peripheral blood of group C were higher than those in group D, while IL-10 in serum was lower than that in group D. WBC count, total protein content, TNFα in bronchoalveolar lavage fluid of group C were higher than those in group D, while IL-10 was lower than group D. (3) Under light microscope, the pathological changes of lung, liver and ileum in group C were obviously more than those in group D and B, and group A was normal. Conclusion Glutamine protects the gastrointestinal function of TPN rats, enhances the anti-infective capacity of the lungs and alleviates the damage of other vital organs caused by severe infections.