谷氨酰胺在危重病患者中的应用

Glutamine in critical patients

目的探讨危重病患者中早期经静脉应用谷氨酰胺(glutamine,Gln)的临床价值。方法42例患者随机分成两组(对照组和Gln组),Gln组进行Gln治疗(100 mL/d,共7 d)。治疗前后检测患者体质量、白蛋白、谷胱甘肽(GSH)、握力的变化和肠功能不全的发生率。结果体质量两组治疗前后比较差异无显著性(P>0.05)。白蛋白、握力和GSH Gln组治疗后非常显著高于治疗前(P<0.01);白蛋白对照组治疗后较治疗前显著增高(P<0.05),但握力和GSH治疗前后均无显著变化(P>0.05);肠功能不全的发生率Gln组为4.8%,显著低于对照组(28.6%,P<0.05)。结论在危重病患者疾病早期通过静脉途径外源性地补充Gln,有效改善了患者的营养状况;使患者血浆中的GSH水平增高,加强了机体的抗氧化能力;减少了患者肠功能不全的发生率。

Objective To evaluate the effects of glutamine（Gln） administrated by vein in critical patients. Methods Forty- two patients were randomly divided into 2 groups, one was the control group, the other was the glutamine treatment group （ glutamine 100 mg/d for 7 days ）. The body weight, glutathione（GSH） level, albumin level, grip strength and the ratio of intestinal dysfunction were observed before and after treatment. Results No significant changes in two groups of the body weight（ P〉0. 05 ）. The albumin level, the grip strength and the GSH level in the glutamine treatment group after glutamine administration was very significantly higher than that before treatment（ P〈0.01）, and there were not significant changes in the control group for the body weight, the GSH level, and the grip strength （ P〉0.05 ）. The albumin level in control group was significant improved （ P〈0. 05）. The ratio of intestinal dysfunction in the glutamine treatment group（ 4.8%） was significantly lower compared with that in the control group （28. 6 %, P〈0.05）. Conelusions Glutamine administrated by vein at early stage of critical patients achieved ideal effect improve patients＂ nutrition status; increase GSH level in plasm, then improves patients＂ antioxidant system; decrease the ratio of intestinal dysfunction.