丙氨酸-谷氨酰胺对危重症患者肠功能障碍的保护作用

Effects of Alanyl-Glutamine on Protection of Intestinal Dysfunction in Patients with Severe Disease

目的:观察丙氨酰-谷氨酰胺(Aln-Gln)双肽对危重症患者肠功能障碍的影响。方法:20例危重症患者随机分为2组,即治疗组和对照组,每组各10例。治疗组使用基础治疗+静脉供给Aln-Gln双肽;对照组仅使用基础治疗。分别于治疗前、治疗后7天评估患者的肠道功能并检测其血浆Gln浓度、尿乳果糖/甘露醇比值(L/M)、血浆二胺氧化酶(DAO)。结果:20例患者中发生肠功能障碍者占了85%;治疗后7天,治疗组肠道功能的评分明显降低(P<0.05)。治疗后第7天治疗组病人的血浆Gln浓度较治疗前明显升高(P<0.05),治疗后第7天治疗组病人尿L/M和血浆DAO均显著低于对照组(P<0.05)。结论:危重症患者极易引起肠功能障碍,肠外供给Aln-Gln能提高血浆Gln浓度,改善肠道粘膜屏障功能从而维护肠道功能。

Objective：To study the effect of Alanyl-Glutamine （Aln-Gln） on preventing intestinal dysfunction in patients with severe disease. Methods： 20 seriously ill patients were divided into two groups randomizedly： therapy group （intravenous administration of Aln-Gln dipeptide; and control group （received standard therapy）. Serum concentrations of glutamine（Gln）, diarnine oxidase（DAO） and urine lactulose/mannito（L/M）ratio were measured before and after treating. All patients＇ intestinal function were evaluated before and after treating as well. Results： About 85% of the patients occurred in intestinal dysfunction.Serum Gin concentration was significantly decreased in control group and increased in therapy group. Urine L/M ratio and serum concentrations of DAO were significantly increased in control group and decreased in therapy group. Conclusions： Parenterally administration of Aln-Gln dipeptide could increase the level of serum Gin, maintain the intestinal barrier and prevent intestinal dysfunction.