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Influence of glutamine and caecostomy/colonic irrigation on gut bacteria/endotoxin translocation in acute severe pancreatitis in pigs
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- Author:
- No author available
- Journal Title:
- WORLD CHINESE JOURNAL OF DIGESTION
- Issue:
- 2
- DOI:
- 10.3969/j.issn.1009-3079.1999.02.016
- Key Word:
- 胰腺炎;谷氨酰胺;内毒素;细菌易位
Abstract： 目的观察静脉内滴注谷氨酰胺(Gln)对急性重症胰腺炎(ASP)后肠源性细菌/内毒素易位的保护作用.方法选健康长白种猪27头,体重17kg～22kg,雌雄不限,随机分为5组. 组Ⅰ:假手术对照组(n=5);组Ⅱ:ASP对照组(n=5);组Ⅲ:ASP+甘氨酸(Gly)组(n=5);组Ⅳ:ASP+Gln组(n=6);组Ⅴ:ASP+Gln+盲肠造口、结肠灌洗组(n=6). 在麻醉状态下,进腹向胰总管内注入1mL/kg 50g/L牛磺胆酸钠混合液[内含胰蛋白酶(8～10)×106 BAEEU/L,pH 7.6]诱导ASP. 以9g/L NaCl磷酸盐缓冲液取代50g/L牛磺胆酸钠混合液即为假手术对照组. 采集腔静脉血作内毒素测定(鲎试剂法). ASP后72h,采集门、腔静脉血作系列细菌定量培养和细菌鉴定. 然后推注100g/L氯化钾20mL处死后立即进胸腹取大小肠系膜淋巴结、肺组织、肺门淋巴结、胰腺组织,称重后研磨成组织匀浆,并作细菌定量培养和细菌鉴定.结果静脉内直接输注Gln后可使血浆中Gln浓度较组Ⅰ、组Ⅱ明显升高(P均＜0.01). 静脉内Gln支持或Gln+盲肠造口、结肠灌洗均可明显降低血浆内毒素水平,且使血液和组织器官中易位的细菌数量均出现非常显著的下降.结论静脉内Gln支持可显著地升高血浆Gln水平. 同时可显著地减轻ASP后肠源性细菌/内毒素易位.
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