Effect of enteraR ecoimmunonutrition on hepatic injury in swine with acute necrotizing pancreatitis / 中华临床营养杂志

ABSTRACT

ObjectiveTo evaluate the effect of enteral ecoimmunonutrition (EIN) on hepatic injury in swine with acute necrotizing pancreatitis (ANP).MethodWith 20 pigs,swine model of ANP was induced by injecring 5％ sodium taurocholate into the pancreatic duct.24 hours after the ANP models were established,2 pig were dead,and the remaining 18 pigs were randomly divided into total parenteral nutrition (TPN) group ( n =6),elemental enteral nutrition (EEN) group ( n =6 ),and EIN group ( n =6 ),and received nutrition support for 8 days.The level of plasma endotoxin and serum concentrations of AST,ALT,TNF-α,and IL-6 were measured at different time points ( before model establishment,24 hours after model establishment,and the 1,2,4,8 days of nutrition support).All the pigs were sacrificed after the 8-day nutrition support,and ascites quantity,hepatic malondialdehyde (MDA),superoxide dismutase (SOD) were measured.The mRNA expression of TNF-α and IL-6 in hepatic tissue were detected by RT-PCR.Pathologic changes of the livers were analyzed.Results24 hours after the ANP models were established,the plasma endotoxin,AST,ALT,TNF-α,IL-6 in EIN group were significantly higher than the levels before model establishment ( all P ＜ 0.01 ),but not significantly different from the 9ther 2 groups.After 8 days of nutrition support,the above 5 indexes in EIN group were significantly lower than those in TPN group and EEN group ( all P ＜ 0.05 ).In addition,the ascites quantity,hepatic concentration of MDA,the expression of TNF-α and IL-6,and hepatic pathological score in EIN group were lower than those of TPN group and EEN group,while hepatic SOD activity was higher in EIN group than in the other 2 groups (all P ＜ 0.05 ).ConclusionEarly EIN could attenuate hepatic injury in ANP from various aspects.