Effects Of Enteral Immunonutrition On Inflammation Reaction And Immune Function Of Severe Acute Pancreatitis Rats

[Background and Objective]Severe acute pancreatitis(SAP) come on be taken bad in a extremely dangerous state,usually combination shock,respiration crock up ect. multiple organ dysfunction syndrome(MODS), the case fatality rate of severe acute pancreatitis is 30%~50%. The pathways of damage are similar, whatever the etiology of pancreatitis, with three phases of progression: local acinar injury, systemic response, and generalized sepsis. The proinflammatory response is countered by an anti-inflammatory response, and an imbalance between these two systems leads to localized tissue destruction and distant organ damage. The present knowledge indicates that cytokines lie at the heart of the problem and are involved in all aspects of the cascade leading to systemic inflammatory response syndrome and multiple organ dysfunction syndrome. The studies are to evaluate the influence of enteral immunonutrition therapy on inflammation reaction and immune function of SAP rats in the early phase of the disease. [Methods]Create severe acute pancreatitis rats by anti-pressure injection of sodium taurocholate into the biliopancreatic duct. Before the severe acutepancreatitis rats are modeled, 10 healthy SD rats were set aside for measuring their blood amylase and CD3+> CD4+> CD8+ in peripheral blood. In addition, 60 SAP rats were divided randomly into total parenteral nutrition group(TPN group,20),traditional enteral nutrition group(EN group,20) and enteral immunonutrition (SEN group,20).As base therapy with Octreotide, during supporting nutrition 14 days, specimen were collected at different time. Blood amylase;TNF- a ,IL-10 in blood plasma and CD3+> CD4\ CD8+ in peripheral blood were measured. [Results](1) After modeling 24h,TNF- a of these three groups were all high and IL-10 were low. At the fourth day, TNF- a reduced sharply, however, IL-10 increased to the highest level, and after that,IL-10 decreased also. At the seventh day TNF- a and IL-10 were significantly lower in the SEN group than those in the TPN and EN groups (all P<0.05). And at the fourteenth day TNF- a ,IL-10 were still significantly lower than them (P<0.05). (2) CD3+, CD4+ and CD4+ / CD8+ were all significantly higher in the SEN group than those in the TPN group and EN group at the seventh day and at the fourteenth day (P<0.05). (3) Blood amylase was normal in the SEN group at the seventh day and it was significantly lower than the TPN and EN groups(P<0.05).At the ninth day blood amylase was also normal in the TPN group and EN group. The fourteen daysmortality of severe acute pancreatitis rats was also significantly lower in the SEN group than that in the TPN and EN groups.[Conclusions]Enteral immunonutrition accommodated the cytokines efficiently;strengthened the immune function;shorten the course and decreased the mortality of severe acute pancreatitis rats.