丙氨酰-谷氨酰胺对重型颅脑损伤后肠黏膜屏障损害的保护作用

Protective effects of alany-glutamine(Ala-Gln) on intestinal mucosa barrier damage after severe brain injury

目的探讨丙氨酰-谷氨酰胺(Ala-Gln)对重型颅脑损伤后肠黏膜屏障的影响。方法将39名重型颅脑损伤患者随机分为治疗组(Ala-Gln强化的营养支持,21例)和对照组(普通营养支持,18例),监测伤后1、3、5、7 d尿乳果糖排泄率、血浆二胺氧化酶(DAO)、D-乳酸和内毒素的变化。结果伤后1 d治疗组较对照组尿乳果糖排泄率、血浆DAO、内毒素降低不明显,伤后3、5、7 d治疗组尿乳果糖排泄率、血浆DAO、D-乳酸和内毒素水平较对照组明显降低(P<0.05)。结论丙氨酰-谷氨酰胺对重型颅脑损伤后早期肠黏膜屏障损害有一定的保护作用。

[Objective] To investigate the effect of Ala-Gln on intestinal mucosa barrier after severe brain injury. [ Methods ] 39 patients with severe brain injury were randomized into treatment group （nutrition supported treatment enriched with Ala-Glu, 21cases） and control group （nutrition supported treatment only, 18 cases）. The dynamic changes of urine excreted rate of lactulose and serum levels of DAO, D-lactate and endotoxin on day 1,3,5,7 after brain injury were measured. [ Results ] Compared with control group, the urine excreted rate of lactulose and serum level of DAO and endotoxin in treatment group on day 1 after brain injury were slightly reduced, while all four in- dexes were significantly reduced on day 3,5,7 （P 〈0.05）. [ Conclusion ] Ala-Gln has probably protected effects on early intestinal mucosa barrier damage after severe brain injury.