腹部手术后患者血浆谷氨酰胺的变化及对肠道通透性的影响

The changes of plasma glutamine and its influence on intestinal permeability after abdominal surgery

目的：观察腹部手术后血浆Ｇｌｎ浓度变化及对肠道通透性的影响。方法：将２５例腹部手术病人分为对照组、补充生理剂量Ｇｌｎ（０．３ｇ／ｋｇ·ｄ－１）组和补充２倍生理剂量Ｇｌｎ（０．６ｇ／ｋｇ·ｄ－１）组。测定口服９９ｍＴｃ－ＤＴＰＡ后尿排出量来反映肠道通透性。结果：显示腹部手术后禁食病人血Ｇｌｎ水平明显下降，而肠道通透性显著升高，静脉补充Ｇｌｎ后血Ｇｌｎ水平恢复正常。生理剂量Ｇｌｎ仅部分抑制术后肠道通透性的升高，给予Ｇｌｎ０．６ｇ／ｋｇ则能使肠道通透性恢复正常。结论：腹部手术后应补充高于生理剂量的Ｇｌｎ，以抑制肠道通透性升高。

Objective:To observe the changes of plasma glutamine and its influence on intestinal permeability after abdominal surgery. Methods:The twenty five patients were randomized allocated to control group,physiological dose group administrated glutamine(Gln) 0.3 g/(kg·d) and double dose group administrated Gln 0.6 g/(kg·d).Intestinal permeability was assessed by the 24 h urinary recovery of orally gave 99m Tc DTPA. Results:It was significant that the plasma Gln concentration declined and intestinal permeability increased after gastro intestinal surgery.In the physiological Gln dose group,intestinal permeability slightly increased after operation.In the double dose group,there was no significant changes of permeability. Conclusion:It suggested that Gln should be supplied by the double physiological dose to protect gut barrier after gastrointestinal surgery.