Department of General Surgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.
Department of Intensive Care Unit, Tianjin Medical University General Hospital, Tianjin, 300052, China.
Inflammation. 2021 Apr;44(2):725-736. doi: 10.1007/s10753-020-01372-0. Epub 2020 Nov 5.
Many patients with ulcerative colitis suffer from malnutrition and intestinal flora disorders, which affect the postoperative intestinal barrier function of the ileal pouch. This study aimed to investigate the effects of enteral nutrition combined with probiotics after ileal pouch-anal anastomosis in rats. Male Sprague-Dawley rats underent ileal pouch-anal anastomosis and were randomly assigned to a control group (standard rat chow), enteral nutrition group (short-peptide enteral nutrition), or probiotic nutrition group (short-peptide enteral nutrition and Lactobacillus acidophilus). The primary outcomes were a histological score and occludin levels in the ileal pouch. The secondary outcomes were nutritional status and fecal flora distribution. The histological scores in the control group were significantly higher than in the enteral nutrition and probiotic nutrition groups (P < 0.05), while occludin levels were significantly lower in the controls compared with the other two groups (P < 0.05). Serum total protein, albumin, transthyretin, and transferrin levels were significantly higher in the probiotic nutrition group, followed by the enteral nutrition and control groups (all P < 0.05). Total fecal flora, and Gram-positive and Gram-negative rods differed significantly among the groups (all P < 0.05), but there were no significant differences in Gram-positive or Gram-negative cocci (all P > 0.05). Enteral nutrition combined with probiotics can effectively protect the intestinal barrier function of the ileal pouch in rats, possibly via the stable distribution of the intestinal flora and good nutritional status.
许多溃疡性结肠炎患者存在营养不良和肠道菌群紊乱，这会影响回肠贮袋术后的肠道屏障功能。本研究旨在探讨回肠贮袋-肛门吻合术后肠内营养联合益生菌对大鼠的影响。雄性 Sprague-Dawley 大鼠行回肠贮袋-肛门吻合术，并随机分为对照组（标准大鼠饲料）、肠内营养组（短肽肠内营养）或益生菌营养组（短肽肠内营养和嗜酸乳杆菌）。主要结局指标为回肠贮袋的组织学评分和紧密连接蛋白水平。次要结局指标为营养状况和粪便菌群分布。对照组的组织学评分明显高于肠内营养组和益生菌营养组（P<0.05），而对照组的紧密连接蛋白水平明显低于其他两组（P<0.05）。益生菌营养组的血清总蛋白、白蛋白、转甲状腺素和转铁蛋白水平明显更高，其次是肠内营养组和对照组（均 P<0.05）。各组的总粪便菌群以及革兰阳性和革兰阴性杆菌均有显著差异（均 P<0.05），但革兰阳性或革兰阴性球菌无显著差异（均 P>0.05）。肠内营养联合益生菌可有效保护大鼠回肠贮袋的肠道屏障功能，可能通过稳定肠道菌群分布和良好的营养状况来实现。
