Goldstein R M, Hebiguchi T, Luk G D, Taqi F, Guilarte T R, Franklin F A, Niemiec P W, Dudgeon D L
J Pediatr Surg. 1985 Dec;20(6):785-91. doi: 10.1016/s0022-3468(85)80044-0.
Total parenteral nutrition (TPN) is vital for the nutritional support of infants with disorders of the gastrointestinal tract that prevent adequate enteral intake. Studies in adult rodents maintained on TPN have demonstrated intestinal atrophy and decreased activity of the brush border enzymes of the small bowel mucosa. We studied the effects of TPN during the phase of rapid intestinal growth and development in piglets. Matched groups of three 6-week-old weaned piglet littermates received a glucose (45 g/kg/d), amino acid (8 g/kg/d), and fat (2.5 g/kg/d) solution intravenously (IV) or by gastrostomy (GF), or were given hog chow (Chow) at an equivalent caloric value for three weeks. No differences were noted in the mean weight gain (13-15 g/kg/d), total serum protein (4.5-4.8 g/dL), BUN (9-12 mg/dL), or Hct (25% to 30%). The IV and GF animals, compared to the Chow animals, had decreased growth of the stomach, small bowel, and pancreas with decreased small bowel mucosal disaccharidase activity. The IV group, compared to Day 0 animal measurements, had decreased small bowel length and weight and pancreatic weight. Histology of the proximal small bowel mucosa in the IV animals showed decreased mucosal depth, villus height, crypt depth, and epithelial cell number from the crypt base to the midvillus. These findings suggest that stomach, small bowel, and pancreatic growth are dependent on the route of administration and/or the composition of the diet, the small bowel mucosa and the pancreas atrophies in young piglets maintained on TPN, the activity of some intestinal brush border disaccharidases are decreased in the small bowel in piglets maintained on either an intravenous or an intragastric infusion of a TPN solution.
全胃肠外营养（TPN）对于患有胃肠道疾病而无法进行充足肠内营养摄入的婴儿的营养支持至关重要。对接受TPN的成年啮齿动物的研究表明，存在肠道萎缩以及小肠黏膜刷状缘酶活性降低的情况。我们研究了TPN在仔猪肠道快速生长发育阶段的影响。将三组6周龄断奶的同窝仔猪匹配分组，分别通过静脉内（IV）给予葡萄糖（45 g/kg/d）、氨基酸（8 g/kg/d）和脂肪（2.5 g/kg/d）溶液，或通过胃造口术（GF）给予，或给予具有同等热量值的猪饲料（Chow），持续三周。在平均体重增加（13 - 15 g/kg/d）、总血清蛋白（4.5 - 4.8 g/dL）、血尿素氮（9 - 12 mg/dL）或血细胞比容（25%至30%）方面未发现差异。与Chow组动物相比，IV组和GF组动物的胃、小肠和胰腺生长减缓，小肠黏膜双糖酶活性降低。与第0天动物测量值相比，IV组小肠长度、重量和胰腺重量均降低。IV组动物近端小肠黏膜的组织学检查显示，从隐窝底部到绒毛中部，黏膜深度、绒毛高度、隐窝深度和上皮细胞数量均减少。这些发现表明，胃、小肠和胰腺的生长取决于给药途径和/或饮食组成，接受TPN的幼龄仔猪的小肠黏膜和胰腺会萎缩，无论是通过静脉内还是胃内输注TPN溶液，仔猪小肠中某些肠道刷状缘双糖酶的活性都会降低。
