谷氨酰胺颗粒剂对严重创伤患者疗效及安全性的临床评价

Effectiveness and safety of glutamine in treatment of critical trauma patients

目的 观察口服谷氨酰胺颗粒剂对严重创伤患者体内谷氨酰胺缺乏的治疗作用及可能发生的不良反应。方法 将受试患者随机分为对照组和治疗组。治疗组口服谷氨酰胺颗粒剂 ;对照组口服同等剂量的安慰剂。比较两组的蛋白质代谢、肠粘膜受损程度、免疫功能、肝肾功能。结果 治疗组血浆谷氨酰胺含量与用药前和对照组相比明显增加 (P <0 .0 5 ) ,而对照组用药后无明显变化。肠道受损程度明显减轻 ,治疗组二胺氧化酶活性、内毒素含量及肠粘膜通透性较用药前及对照组明显下降 (P <0 .0 5～ 0 .0 1) ,血浆内毒素的变化则不明显 (P >0 .0 5 )。治疗组血浆蛋白、白介素 2水平显著高于用药前 (P <0 .0 5 ) ,尿氮含量明显低于对照组 (P <0 .0 1)。结论 服用谷氨酰胺颗粒剂能显著提高血浆谷氨酰胺含量 ,对严重创伤患者谷氨酰胺缺乏的治疗是安全。

Objective To study the effectiveness and safety of glutamine in treatment of critical trauma patients.?Methods Forty two critical trauma patients were randomly divided into two groups: group A (n=21)and group B (n=21) and were treated with glutamine and placebo respectively. After treatment protein metabolism condition,the degree damage of intestinal mucosa, the immunological functions,liver and renal functions of each of the two groups were compared.?Results After treatment,the glutamine content of plasma of group B was markedly higher than before treatment and group A(P<0.05).The activity of diamine oxidase and permeability of intestinal mucosa were markedly decreased than before treatment and that of group A(P< 0.05 0.01),while the variance of endotoxic content of plasma was not significant(P>0.05). The protein content of plasma and the interleukin 2 of group B was obviously higher than before treatment ,while urinary nitrogen of group B was markedly lower than that of group A and before treatment.?Conclusion After treatment, the glutamine content of plasma has been obviously increased. The treatment of glutamine in severe trauma patient is safe and efficient.