口服谷氨酰胺对化疗患者肠屏障功能的保护作用

Protective effect of glutamine on intestinal barrier function in patients receiving chemotherapy

目的观察谷氨酰胺对胃肠肿瘤术后化疗患者肠黏膜的保护作用。方法将胃肠道肿瘤手术后准备行化疗的39例患者分成观察组(22例)和对照组(17例),化疗方案为氟尿嘧啶(5-FU)加四氢叶酸(CF),连续5d。观察组化疗同时口服谷氨酰胺颗粒30g/d,分3次服,连续7d;对照组仅化疗。检测两组患者化疗前后血浆中谷氨酰胺浓度和尿中乳果糖/甘露醇(L/M)比值。结果观察组化疗后血浆中谷氨酰胺浓度为(594.44±81.26)μmol/L,较对照组的(535.42±53.75)μmol/L明显增高(P<0.01);尿中L/M比值治疗组(0.0321±0.0052)较对照组(0.0453±0.007)明显降低(P<0.01)。结论口服谷氨酰胺颗粒能够提高胃肠肿瘤术后化疗患者血谷氨酰胺浓度,减轻化疗后肠黏膜损伤程度,维护肠黏膜屏障功能。

Objective To study the protective effect of glutamine （Gin） on intestinal permeability in patients receiving chemotherapy. Methods Thirty-nine patients with gastrointestinal cancer after operation were randomly divided into Gin and control groups, and received oral administration of glutsmine （30 g/d） for 7 days（ n =22） or not（ n = 17） . All patients received CF ＋5-FU chemotherapy for 5 days. Serum concentration of glutamine and urinary lactulose/mannitol （L/M） ratio were measured before and 1 day after chemotherapy. Results After chemotherapy, the serum Gin concentration was significantly decreased to （535.42 ± 53.75） μmol/L in the control group and increased to （594. 44 ± 81.26） μmol/L in the Gin group, and there was significant difference between the two groups（ P 〈 0.01 ）. Urine L/M ratio was significantly increased to （0. 0453 ±0. 0078） in the control group and decreased to （0. 0331 ±0. 0061） in the Gln group, and there was significant difference between the two groups after chemotherapy（ P 〈 0. 01 ）. Conclusion Oral administration of glutamine granules can increase serum concentration of glutamine in chemotherapy patients with gastrointestinal cancer and can decrease intestinal permeability, maintain intestinal barrier.