| Objective: To explore the protective effect and mechanism of early enteral nutrition on acute gastrointestinal injury and brain injury after cerebral ischemia-reperfusion injury in rats,so as to provide reference basis for clinical prevention and treatment of ischemic stroke and its gastrointestinal complications.Methods: 32 healthy SD male rats(clean grade,8 weeks old,weight 250 g ～ 300g)were randomly divided into 4 groups: normal control group(Normal group),sham operation group(Sham-operated group),acute cerebral ischemia reperfusion model group(MCAO-model group)and early enteral nutrition treatment group(EEN group),with 8 rats in each group.The acute cerebral ischemia-reperfusion model was made in the Model group and EEN group according to the modified thread occlusion method;the Sham group only cut open the skin,separate nerves,blood vessels and thread,but did not ligate the blood vessels;the control group did not do any treatment.EEN group was given Baepril nutrient solution 6 hours after modeling,4m L/4 times a day,a total of 48 hours,the other three groups were given normal saline intragastric administration,the dose and frequency were the same as above.After 48 hours of experiment,4m L was collected from abdominal aorta of rats in each group,and the contents of IL-6 and TNF-α in serum were detected by ELISA method,brain tissue was stained with red tetrazolium(TTC),part of gastrointestinal tissue was stained with Hmure E,and pathological changes were observed under light microscope.WST-1 method and TBA method were used to detect SOD activity and MDA content in mucosal tissue.Results:1.Results of pathological examination:(1)Gross observation: compared with normal group and sham operation group,gastrointestinal mucosal surface erosion,more ulcers,bleeding spots and bleeding could be seen in the model group,hyperemia,edema and a small amount of erosion could be seen in the treatment group.(2)Microscopically,compared with the normal group and the sham operation group,gastric mucosa in the model group formed ulcers,and in severe cases it could reach to the muscularis mucosae.Intestinal villi adhesion lodging,gland arrangement disorder,with more inflammatory cell infiltration;treatment group gastric mucosal lesions are mild,intestinal glands are still neatly arranged,part of the villi are disordered,a small amount of inflammatory cell infiltration.2.The results of WST-1 detection:(1)the activity of SOD in gastric mucosa:compared with normal group and sham operation group,the activity of SOD in model group and treatment group decreased significantly(P<0.001,P<0.01),and the activity of SOD in treatment group increased compared with model group(P<0.05).(2)SOD activity in intestinal mucosa: compared with normal group and sham operation group,SOD activity in model group and treatment group decreased(P<0.001,P<0.05),and SOD activity in treatment group increased significantly compared with model group(P< 0.01).3.The results of TBA detection:(1)The content of MDA in gastric mucosa:compared with normal group and sham operation group,the content of MDA in model group and treatment group increased significantly(all P<0.001),and the content of MDA in treatment group decreased(P<0.01).(2)The content of MDA in intestinal mucosa: compared with normal group and sham operation group,the content of MDA in model group and treatment group increased(P<0.001,P<0.05),and the content of MDA in treatment group decreased significantly compared with model group(P<0.01).4.The results of ELISA detection: compared with the normal group and the sham operation group,the contents of IL-6 and TNF-α in the model group and treatment group increased(P<0.001,P<0.05),but the contents of IL-6 and TNF-α in the treatment group decreased significantly compared with the model group(P< 0.01).5.TTC staining results: there was no vascular occlusion and no cerebral ischemic injury in the normal group and the sham operation group,so only TTC staining was performed on the brain tissue in the model group and the treatment group.The results showed that the cerebral ischemic infarct area was obviously white in the model group,and the infarct size in the treatment group was slightly smaller than that in the model group.Conclusions:1.Early enteral nutrition can reduce the acute gastrointestinal mucosal injury secondary to cerebral ischemia-reperfusion injury,and its mechanism may be related to the reduction of oxidative stress response of gastrointestinal mucosa.2.Early enteral nutrition can reduce the degree of cerebral ischemia-reperfusion injury,and its mechanism may be related to down-regulating the expression of inflammatory factors IL-6 and TNF-α in serum,thus improving systemic immune inflammatory response. |
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