Iba T, Yagi Y, Kidokoro A, Ohno Y, Kaneshiro Y, Akiyama T
Department of Surgery, Juntendo Urayasu Hospital, Juntendo University School of Medicine, Chiba, Japan.
Nutrition. 1998 Sep;14(9):667-71. doi: 10.1016/s0899-9007(98)00051-3.
Total parenteral nutrition (TPN) is associated with an increased incidence of bacterial translocation (BT) compared with enteral nutrition because of the disuse atrophy of the intestine. In this study, we assessed the effect of adding medium-chain triacylglycerols (MCT) to TPN for the prevention of mucosal atrophy in the intestine. Rats were subjected to either fat-free TPN, TPN with long-chain triacylglycerols (LCT), or TPN with MCT for 5 d and nutrition parameters were evaluated. In another set of rats receiving the same TPN regimen, 0.8 or 0.05 mg/kg endotoxin was administered on day 4. Survival was evaluated and BT to the mesenteric lymph nodes, liver, and systemic blood was measured 24 h later. The mucosal heights of the jejunum and ileum were evaluated concurrently. The survival rate was significantly improved in the MCT group (P < 0.05) at the endotoxin dose of 0.8 mg/kg. The nutrition condition presented by phospholipid, total cholesterol, and total ketone body levels was the best in the MCT group compared to the other groups. The intestinal villous height in the ileum was significantly greater in the MCT group. However, the improvement of BT in MCT group was not statistically significant. In this endotoxin-challenged rat model, survival rate was improved by the supplementation of MCT. This effect may be presented in some part by the improvement in nutrition condition and by the prevention of mucosal atrophy in the intestine.
由于肠道废用性萎缩，与肠内营养相比，全胃肠外营养（TPN）与细菌易位（BT）发生率增加相关。在本研究中，我们评估了在TPN中添加中链甘油三酯（MCT）对预防肠道黏膜萎缩的作用。将大鼠分为无脂TPN组、含长链甘油三酯（LCT）的TPN组或含MCT的TPN组，持续5天，并评估营养参数。在另一组接受相同TPN方案的大鼠中，于第4天给予0.8或0.05mg/kg内毒素。评估存活率，并在24小时后测量向肠系膜淋巴结、肝脏和全身血液的BT情况。同时评估空肠和回肠的黏膜高度。在0.8mg/kg内毒素剂量下，MCT组的存活率显著提高（P<0.05）。与其他组相比，MCT组由磷脂、总胆固醇和总酮体水平所呈现的营养状况最佳。MCT组回肠的肠绒毛高度显著更高。然而，MCT组BT的改善无统计学意义。在这个内毒素攻击的大鼠模型中，补充MCT可提高存活率。这种作用可能部分是通过营养状况的改善和肠道黏膜萎缩的预防来体现的。
