Research On Effects Of Enteral Nutrition And Parenteral Nutrition On Gut Mucosal Barrier Function Recovery

Objective:To investigate the effect of enteral nutrition(EN) and parenteral nutrition(PN) on gut mucosalbarrier function after gastrointestinal surgery.Methods:Forty male Sprague Dawley (SD) rats were randomly divided into four groups：Control(C),parenteral nutrition(PN)group, enteral nutrition(EN)group, the conventional alanyl-glutamine-enriched enteral nutrition (G-EN) group. PN Group,EN Group and G-EN Group receivedCecectomy and gastrostomy with the use of50mg amoxicillin and20mg metronidazoletwice．Each group would be treated with isocaloric and isonitrogenous nutrition for next7daysafter the operation, respectively. Taking5cm terminal ileum and1cm intestines, the morphologyof intestinal epithelial tight junctions can be observed by optical microscopy. For each group,then solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) was used to comparelevels of plasma D-lactate, and test intestinal mucosal permeability And the serumconcentrations of TNF－α was detected by utilizing enzyme linked immunosorbent assay. Thetransmembrane binding proteins (occludin) were measured with immunohistochemistry.Results：For PN Group, intestinal mucosa obviously atrophied and the villus height, crypt depth,mucosal thickness, villus surface area of ileum and transmembrane binding proteins (occludin)were lower than those of rats of C Croup, EN Group and G-EN Group (P<0.05), but D-lactateand level of TNF－α were much higher than other Groups’(P<0.05). For EN Group, intestinalmucosa atrophied, and the villus height, crypt depth, mucosal thickness, villus surface area ofileum and transmembrane binding proteins (occludin) were lower than those of rats of C Group,G-EN Group (P<0.05), however, D-lactate and level of TNF－α were much higher than C andG-EN Groups’(P<0.05). There was no significant difference between G-EN Group and C Groupin the ileal membrane morphology transmembrane binding proteins (occludin) expression level,intestinal mucosa permeability and level of TNF－α(P>0.05).Conclusion:Compared with only supplying enteral nutrition or arenteral nutrition(PN), Alanyl-glutamine-enriched enteral nutrition can maintain gut mucosal barrier function, reduceinflammation, increase intestinal epithelial occludin protein expression, and finally improve the gut mucosal barrier function recovery after gastrointestinal surgery.