Vanderhoof J A, Kollman K A, Griffin S, Adrian T E
Department of Pediatrics, University of Nebraska Medical Center, Omaha, USA.
J Pediatr Gastroenterol Nutr. 1997 Sep;25(3):327-31. doi: 10.1097/00005176-199709000-00016.
Certain nutrients and other trophic factors are highly sensitive stimulants of intestinal adaptation following short bowel syndrome. Growth hormone and glutamine in a modified diet have been shown to enhance nutrient absorption in patients with severe short bowel syndrome. However, neither growth hormone nor glutamine is capable of enhancing adaptation in an animal model. This study was conducted to determine if the combination of glutamine and growth hormone could enhance gut adaptation following massive small bowel resection in the rat.
Thirty-four male rats received 70% jejunoileal resection. The first group received glycine and rat growth hormone, the second glutamine and rat growth hormone, and the third glycine but no growth hormone.
There was no evidence that the combination of glutamine and growth hormone could enhance mucosal mass, mucosal protein, or mucosal DNA levels relative to the other two control groups of animals. Likewise, sucrase activities were not enhanced by glutamine and growth hormone.
It is unlikely that the combination of glutamine and growth hormone will be of benefit in the treatment of patients with short bowel syndrome. The results in previous human studies can be alternatively explained by the long-term nonspecific effect of enteral nutrition on gut adaptation.
某些营养素和其他营养因子是短肠综合征后肠道适应性的高度敏感刺激物。改良饮食中的生长激素和谷氨酰胺已被证明可增强严重短肠综合征患者的营养吸收。然而,生长激素和谷氨酰胺都无法在动物模型中增强适应性。本研究旨在确定谷氨酰胺和生长激素的组合是否能增强大鼠大规模小肠切除术后的肠道适应性。
34只雄性大鼠接受70%空肠回肠切除术。第一组接受甘氨酸和大鼠生长激素,第二组接受谷氨酰胺和大鼠生长激素,第三组接受甘氨酸但不接受生长激素。
没有证据表明谷氨酰胺和生长激素的组合相对于其他两组对照动物能增加黏膜质量、黏膜蛋白或黏膜DNA水平。同样,谷氨酰胺和生长激素也没有提高蔗糖酶活性。
谷氨酰胺和生长激素的组合不太可能对短肠综合征患者的治疗有益。先前人体研究的结果可以通过肠内营养对肠道适应性的长期非特异性作用来解释。