Effect Of Early Eenteral Nutrition And Selective Decontamination Of The Digestive Tract On The Barrier Function Of The Gut In Dogs With Acute Necrotizing Pancreatitis

Objectives:To evaluate the effect of early enteral nutrition(EEN) and selective decontamination of the digestive tract (SDD) on the Endotoxin translocation and systemic inflammatory response syndrome and the structure and function of the gut in dogs with acute necrotizing pancreatitis.Methods:ANP model was induced by injecting 1ml/kg of combined solution of 5% sodium taurocholate and trypsin into the pancreas via pancreatic duct.20 dog were divided into NS group,SDD group,EEN group,SDD and EEN group(ESDD). The dogs were treated by either saline, EEN,SDD,orESDD starting at 24 hours after operation lasting for 5 days The levels of amylase,interleukin-1(IL-1),tumor necrotize factor(TNF-α)Endotoxin,amylas,En-dotoxin,D(-)-lactate,diamine oxidase(DAO) in the peripheral plasma were measured every day.The model took 2g of lactulose and 1g mannitol and 6 hours of urine wes collected at the 2th and 5th day.The L and M cocentration was analyzed by HPLC-RI.The excretion of L and M and the L/M ratio was calculated. The activity of PMN myeloperoxidase (MPO) in pancreas was determined by zymohistochemistry.The height of the villi and the thickness of mucosa were measured. The total DNA of microbial communities in dog's fecal samples were amplified by using the ERIC primers to generate community fingerprints.Results:1: The levels of interleukin-1β(IL-1β),tumor necrotize factor-α(TNF-α) in SDD group, EEN group and ESDD group were less than NS group at 4th and5th day2:The levels of Endotoxin,D(-)-lactate,diamine oxidase(DAO) in the peripheral plasma in SDD group and EEN group were less than NS group,but it was more than ESDDgroup.3:The L/M ratio in SDD group and EEN group wes more than NS group,but it was more than ESDD group at the 5th day.It was not reach statistically significant difference at the 2th day. 4:The height of the villi and the thickness of mucosa of the intestinel and colon improve in EEN group and EEN and SDD group as compared with those in NS group and SDD group.5: The makeup and distributin of intestinal microbial communities of EEN groups is similar in every day. It had great difference in NS groups,SDD group and ESDD group at different day.Conclusion:1 :EEN,SDDand ESDD can decrease the endoxin translocation and systemic inflammatory response in ANP.2:EEN, SDD or ESDD can improve gut metabolism,decrease the extent of mucosal atrophy,and assist in the maintenance of the mucosal barrier function in ANP.ESDD is the best therapy.3:EEN can maintain the intestinal microbial communities.NS,SDD,ESDD can change the intestinal microbial communities.