• 上海交通大學(xué)附屬第六人民醫(yī)院外科(上海200233);;
  • 通訊作者: 秦環(huán)龍,E-mail: hlqin@sjtu.edu.cn;

目的 探討谷氨酰胺(Gln)聯(lián)合生長(zhǎng)激素(GH)對(duì)膿毒癥大鼠腫瘤壞死因子-α(TNF-α)、白介素-1(IL-1)、IL-6、皮質(zhì)醇及三甲基組氨酸(3-MH)濃度和氨基酸代謝的影響。方法 79只SD大鼠,隨機(jī)取其中10只設(shè)為對(duì)照組,另69只用盲腸結(jié)扎穿孔法建立腹腔感染、頸靜脈置管腸外營(yíng)養(yǎng)(PN)模型后,將其中存活超過(guò)6 d的大鼠30只均分為3組: 膿毒癥組、Gln組和Gln+GH組。第6 d處死動(dòng)物,取門(mén)靜脈血,用酶聯(lián)免疫吸附法(ELISA)檢測(cè)血清TNF-α、IL-1、IL-6和皮質(zhì)醇濃度; 氨基酸自動(dòng)分析儀檢測(cè)血清氨基酸濃度; 取大鼠趾長(zhǎng)伸肌組織,采用高效液相色譜法檢測(cè)骨骼肌組織中3-MH濃度。結(jié)果 血清TNF-α、IL-1、IL-6及皮質(zhì)醇濃度對(duì)照組均低于膿毒癥組(P<0.05,P<0.01),Gln+GH組及Gln組均低于膿毒癥組(P<0.05, P<0.01),Gln+GH組亦低于Gln組。與對(duì)照組相比,膿毒癥組血清總氨基酸濃度升高(P<0.05),尤以谷氨酸和支鏈氨基酸明顯(P<0.05),Gln濃度明顯降低(P<0.05); Gln組和Gln+GH組與膿毒癥組相比,血清總氨基酸濃度降低(P<0.05),尤以Gln+GH組降低明顯(P<0.05),Gln濃度明顯升高(P<0.05)。骨骼肌組織中3-MH濃度以膿毒癥組為最高,Gln組又高于Gln+GH組(P<0.01)。結(jié)論 添加GH和Gln的PN,能降低細(xì)胞因子水平,改善氨基酸代謝。

引用本文: 劉敏豐,高志光,秦環(huán)龍. 生長(zhǎng)激素和谷氨酰胺對(duì)膿毒癥大鼠細(xì)胞因子和氨基酸代謝的影響△. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006, 13(5): 535-539. doi: 復(fù)制

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  2. 2.  劉敏豐, 秦環(huán)龍. 外科危重疾病時(shí)肌肉惡病質(zhì)的發(fā)生機(jī)制研究進(jìn)展 [J]. 中國(guó)危重病急救醫(yī)學(xué)雜志, 2004; 16(11)∶695.
  3. 3.  Steiger E, Vars HM, Dudrick SJ. A technique for long-term intravenous feeding in unrestrained rats [J]. Arch Surg, 1972; 104(3)∶330.
  4. 4.  Lidington D, Ouellette Y, Li F, et al. Conducted vasoconstriction is reduced in a mouse model of sepsis [J]. J Vasc Res, 2003; 40(2)∶149.
  5. 5.  沈通一, 秦環(huán)龍, 佟大年, 等. 腸外腸內(nèi)營(yíng)養(yǎng)對(duì)腹腔感染大鼠腸上皮緊密連接和屏障功能的影響 [J]. 中華普通外科雜志, 2005; 20(3)∶174.
  6. 6.  吳焱秋, 柴家科, 黎君友, 等. 大鼠嚴(yán)重燙傷早期血漿游離氨基酸濃度的變化 [J]. 中華燒傷雜志, 2001; 17(4)∶215.
  7. 7.  Okamura K, Okuma T, Tabira Y, et al. Effect of administered human growth hormone on protein metabolism in septic rats [J]. JPEN J Parenter Enteral Nutr, 1989; 13(5)∶450.
  8. 8.  Gamrin L, Essen P, Hultman E, et al. Protein-sparing effect in skeletal muscle of growth hormone treatment in critically ill patients [J]. Ann Surg, 2000; 231(4)∶577.
  9. 9.  Millward DJ, Jepson MM, Omer A. Muscle glutamine concentration and protein turnover in vivo in malnutrition and in endotoxemia [J]. Metabolism, 1989; 38(8 Suppl 1)∶6.
  10. 10.  桑劍鋒, 吳文溪, 許 勤, 等. 添加丙氨酰谷氨酰胺胃腸外營(yíng)養(yǎng)對(duì)燙傷大鼠蛋白質(zhì)代謝的作用 [J]. 現(xiàn)代醫(yī)學(xué), 2003; 31(6)∶362.
  11. 11.  盧才教, 林 才, 徐建軍, 等. 聯(lián)合應(yīng)用谷氨酰胺和重組人生長(zhǎng)激素對(duì)嚴(yán)重?zé)齻颊叩鞍状x的影響 [J]. 中華燒傷雜志, 2004; 20(4)∶220.