谷氨酰胺对新生儿上消化道出血患儿SOD、MDA的影响

Effect of glutamine on SOD and MDA in neonates with upper digestive tract hemorrhage

目的观察谷氨酰胺对上消化道出血患儿超氧化物歧化酶(SOD)、丙二醛(MDA)的影响并探讨其安全性。方法选取嘉兴市第一医院与嘉兴市妇幼保健院2016年至2017年期间收治的100例上消化道出血新生儿,根据随机数字表法,将患儿分为实验组和对照组,各50例。对照组给予0.8mg/kg奥美拉唑静滴,2次/天;实验组在对照组基础上再给予100mg/kg谷氨酰胺颗粒口服,3次/天,一个疗程为3天。观察并记录实验组和对照组SOD活性、MDA、临床疗效及不良反应发生率,并对其安全性进行探讨与分析。结果治疗后,实验组SOD(44.64±5.83IU/mL)显著高于对照组(34.26±5.41IU/mL),差异有统计学意义(t=9.23,P<0.01)。治疗后,实验组MDA(31.22±6.74μmol/L)显著低于对照组(43.47±6.81μmol/L),差异有统计学意义(t=9.04,P<0.01)。实验组咖啡样物或鲜血停止时间(14.58±4.42h)显著少于对照组(25.41±4.76h),差异有统计学意义(t=11.79,P<0.01)。实验组隐血试验转阴时间(30.93±10.42h)显著少于对照组(57.78±10.21h),差异有统计学意义(t=13.01,P<0.01)。实验组治疗有效率为98.00%,显著高于对照组76.00%(χ~2=35.10,P<0.01)。实验组患儿呕吐1例,便秘1例,腹泻1例;对照组患儿呕吐2例,便秘1例,皮疹1例,两组不良反应发生率差异无统计学意义(P>0.05)。结论谷氨酰胺对于抑制患儿上消化道出血的氧化应激反应,保护胃黏膜损伤组织具有显著作用,疗效明显,安全性较高,值得临床广泛推行。

Objective To observe the effect of glutamine on superoxide dismutase（SOD）and malonaldehyde（MDA）in neonates with upper digestive tract hemorrhage and to explore its safety.Methods A total of 100 neonates with upper gastrointestinal tract hemorrhage treated in the First Hospital of Jiaxing and Jiaxing Maternity and Child Health Care Hospital during 2016 to 2017 were selected and divided into experimental group and control group by random number table method with 50 cases in each group.The neonates in the control group were given intravenous drip of omeprazole with 0.8 mg/kg,twice a day,while besides the therapy for the control group,the neonates in the experimental group were given oral administration of glutamine granules with 100 mg/kg,3 times a day,and one course was 3 days.The SOD activity,MDA,clinical efficacy and incidence of adverse reactions in neonates in two groups were observed and recorded,and its security was discussed and analyzed.Results After treatment,the SOD activity in the experimental group（44.64±5.83 IU/mL）was significantly higher than that in the control group（34.26±5.41 IU/mL）,and the difference was statistically significant（t=9.23,P0.01）.After treatment,MDA of neonates in the experimental group（31.22±6.74μmol/L）was significantly lower than that of neonates in the control group（43.47±6.81μmol/L）,and the difference was statistically significant（t=9.04,P0.01）.The stop time of coffee-ground vomiting or fresh blood bleeding in the experimental group（14.58±4.42 h）was significantly shorter than that in the control group（25.41±4.76 h）with significant difference（t=11.79,P0.01）.The time of occult blood test results turning to negative in the experimental group（30.93±10.42 h）was significantly shorter than that in the control group（57.78±10.21 h）,and the difference was statistically significant（t=13.01,P0.01）.The effective rate of the experimental group was 98.00%,which was significantly higher than that of the control group（76.00%）（χ~2=35.10,P0.01）.In the experimental group,there was 1 case of vomiting,1 case of constipation and 1 case of diarrhea,while in the control group,there were 2 cases of vomiting,1 case of constipation,1 case of rash.There was no significant difference in the incidence of adverse reactions between two groups（P0.05）.Conclusion Glutamine is of significant effect in inhibiting oxidative stress reaction and protecting gastric mucosa in children with upper digestive tract bleeding.It has obvious efficacy and high safety,and is worthy of wide clinical application.