摘要目的以大鼠异基因异位全小肠移植(SD→Wistar)及TPN模型为研究对象,观察了小肠移植术后应用重组人生长激素对移植小肠结构修复和受体大鼠蛋白质代谢的促进作用.方法 20只小肠移植受体大鼠随机分为两组,试验组在TPN支持的基础上加用重组人生长激素1 U* kg-1*d-1 ,比较两组移植小肠粘膜形态学参数及受体大鼠蛋白质代谢指标 .结果与标准TPN支持相比,加用重组人生长激素能显著促进移植小肠粘膜结构的恢复,各项形态学参数在术后第14天可基本恢复正常,生长激素还能明显促进受体大鼠的蛋白质代谢,减少蛋白质分解,促进正氮平衡,纠正低白蛋白血症,减轻体重下降的幅度.结论生长激素能够促进移植小肠粘膜结构的修复,改善受体大鼠的蛋白质代谢,可望作为一种有效的代谢调理手段用于临床小肠移植.

abstractsObjective To observe the effects of recombinant human growth hormone (rhGH) on graft struc ture and recipient protein metabolism in rat small bowel transplantation (SBT) a nd total parenteral nutrition (TPN) models.Methods Twenty recipients of rat allogeneic heterotopic small bowel transplants (SD→Wis tar) were divided into two groups (GH group and control group). Both groups wer e supported by standard TPN. Acute rejection was suppressed with CsA 10 mg*kg -1*d-1 intramuscularly. All rats in the experimental group recei ved subcutaneous rhGH 1 U*kg-1*d-1 after transplantation. Morph ological mucosal indices of transplanted gut and metabolic parameters such as bo dy weight, nitrogen balance, urinary 3-methyl histidine excretion and serum alb umin of the recipients were compared between two groups.Results The application of rhGH promoted graft recovery significantly compared with stan dard TPN support alone. On postoperative day 14, all morphological indexes of t ransplanted gut recovered to the preoperative state. Protein metabolism in the recipient was also significantly improved. rhGH decreased the catabolism of pro tein, accelerated regaining of positive nitrogen balance and corrected hypoalbum inemia.Conclusion GH is an effective metabolic intervention in SBT. It may promote the structural repair of the graft and correct the metabolic disturbance. It is useful in imp roving the outcome of clinical SBT.