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目的 探讨单纯肠外营养 (PN)与添加生长激素 (GH)的PN对短肠大鼠残留小肠代偿的作用及作用机制。方法 将 2 0只短肠SD大鼠随机分成PN组及PN +rhGH组。行细胞增殖核抗原 (PCNA)测定、原位末端标记 (TUNEL)染色及bcl 2、BaxmRNA测定。结果 PN组残留小肠粘膜明显萎缩 ,PN +rhGH组肠萎缩显著改善。PCNA表达在PN组降低 [(8.37± 2 .2 3)个 /视野 ],PN +rhGH组增高 [(19.2 8± 3.2 5 )个 /视野 ],差异有非常显著性 (P <0 .0 1)。凋亡指数在PN组增高 [(2 2 .32± 3.84)个 / 10 0细胞 ],PN +rhGH组降低 [(8.0 6± 2 .2 3)个 / 10 0细胞 ],差异有非常显著性(P <0 .0 1)。bcl 2mRNA表达在PN组降低 (0 .2 0± 0 .0 3) ,在PN +rhGH组增高 (0 .44± 0 .0 6 ) ,BaxmRNA表达则相反。结论 单纯PN使短肠大鼠残留小肠粘膜明显萎缩 ,rhGH通过促进肠粘膜上皮细胞增生与抑制肠粘膜上皮细胞凋亡 ,显著促进残留小肠的代偿适应。
Objective To investigate the effect and mechanism of parenteral PN (PN) and growth hormone (GH) -induced PN on residual intestinal compensatory in short-term rats. Methods Twenty short SD rats were randomly divided into PN group and PN + rhGH group. PCNA, TUNEL and bcl-2, Bax mRNA were measured. Results The residual small intestinal mucosa of PN group was significantly atrophied, and the intestinal atrophy of PN + rhGH group was significantly improved. The PCNA expression was significantly lower in PN group [(8.37 ± 2.23) / visual fields] and in PN + rhGH group (19.2 8 ± 3.2 5) / visual fields, the difference was statistically significant (P <0.01) ). The apoptotic index in PN group was significantly higher than that in PN group [(2.32 ± 3.84) / 10 0 cells], while in PN + rhGH group [(8.06 ± 2.23) / 10 0 cells], the difference was significant (P <0. 01). The expression of bcl-2mRNA in PN group decreased (0.20 ± 0.30), increased in PN + rhGH group (0.44 ± 0.06), while Bax mRNA expression was opposite. Conclusions PN alone significantly reduced the residual intestinal mucosa in short-bowel rats. RhGH promoted the compensatory adaptation of residual small intestine by promoting the proliferation of intestinal epithelial cells and inhibiting the apoptosis of intestinal mucosa epithelial cells.