肠外与肠内营养
腸外與腸內營養
장외여장내영양
PARENTERAL & ENTERAL NUTRITION
2010年
1期
13-16
,共4页
谷氨酰胺%丙氨酰-谷氨酰胺双肽%肠道通透性%全身炎性反应%加速康复外科
穀氨酰胺%丙氨酰-穀氨酰胺雙肽%腸道通透性%全身炎性反應%加速康複外科
곡안선알%병안선-곡안선알쌍태%장도통투성%전신염성반응%가속강복외과
Glutamine%Alanyl-glutamine dipeptide%Intestinal permeability%Systemic inflammatory response%Fast track surgery
目的:观察丙氨酰-谷氨酰胺(Aln-Gln)双肽对腹部手术后病人早期肠道通透性的影响,并探讨其与术后全身炎性反应的关系.方法:20例腹部手术病人分为研究组和对照组,每组各10例.从术后第1天开始,研究组静脉供给Aln-Gln双肽0.5 g/(kg·d),共4 d;对照组用同等容量生理盐水替代.于手术前、后分别检测血浆Gln浓度、尿乳果糖/甘露醇比值(L/ M)、血浆二胺氧化酶(DAO)、白细胞介素-6(IL-6)和临床指标 (体温、心率、呼吸和血白细胞计数)等. 结果:术后第5天,对照组病人的血浆Gln浓度较术前下降16%,研究组较术前升高17%,且研究组显著高于对照组(P<0.05).研究组病人术后第5天尿L/M、血浆DAO和 IL-6显著低于对照组;研究组病人术后全身炎症反应综合征(SIRS)的发生率亦显著低于对照组. 结论:术后静脉供给Aln-Gln能提高血浆Gln浓度,改善肠屏障功能,减轻术后早期全身炎性反应,有利于术后的快速康复.
目的:觀察丙氨酰-穀氨酰胺(Aln-Gln)雙肽對腹部手術後病人早期腸道通透性的影響,併探討其與術後全身炎性反應的關繫.方法:20例腹部手術病人分為研究組和對照組,每組各10例.從術後第1天開始,研究組靜脈供給Aln-Gln雙肽0.5 g/(kg·d),共4 d;對照組用同等容量生理鹽水替代.于手術前、後分彆檢測血漿Gln濃度、尿乳果糖/甘露醇比值(L/ M)、血漿二胺氧化酶(DAO)、白細胞介素-6(IL-6)和臨床指標 (體溫、心率、呼吸和血白細胞計數)等. 結果:術後第5天,對照組病人的血漿Gln濃度較術前下降16%,研究組較術前升高17%,且研究組顯著高于對照組(P<0.05).研究組病人術後第5天尿L/M、血漿DAO和 IL-6顯著低于對照組;研究組病人術後全身炎癥反應綜閤徵(SIRS)的髮生率亦顯著低于對照組. 結論:術後靜脈供給Aln-Gln能提高血漿Gln濃度,改善腸屏障功能,減輕術後早期全身炎性反應,有利于術後的快速康複.
목적:관찰병안선-곡안선알(Aln-Gln)쌍태대복부수술후병인조기장도통투성적영향,병탐토기여술후전신염성반응적관계.방법:20례복부수술병인분위연구조화대조조,매조각10례.종술후제1천개시,연구조정맥공급Aln-Gln쌍태0.5 g/(kg·d),공4 d;대조조용동등용량생리염수체대.우수술전、후분별검측혈장Gln농도、뇨유과당/감로순비치(L/ M)、혈장이알양화매(DAO)、백세포개소-6(IL-6)화림상지표 (체온、심솔、호흡화혈백세포계수)등. 결과:술후제5천,대조조병인적혈장Gln농도교술전하강16%,연구조교술전승고17%,차연구조현저고우대조조(P<0.05).연구조병인술후제5천뇨L/M、혈장DAO화 IL-6현저저우대조조;연구조병인술후전신염증반응종합정(SIRS)적발생솔역현저저우대조조. 결론:술후정맥공급Aln-Gln능제고혈장Gln농도,개선장병장공능,감경술후조기전신염성반응,유리우술후적쾌속강복.
Objective: The study was designed to observe the effects of alanyl-glutamine (Aln-Gln) dipeptide on postoperative intestinal permeability and systemic inflammatory response.Methods: A prospective,randomized and controlled trial was taken.20 patients who underwent abdominal surgery were randomized into two groups: study group (intravenous administration of Aln-Gln dipeptide,0.5 g /(kg·d),for 4 days,n=10) and control group (equal normal saline as placebo,for 4 days,n=10).Temperatures,heart rates and respiration rates of all patients were daily recorded during administration.The white blood cell counts ,serum concentrations of glutamine (Gln),diamine oxidase (DAO) and interleukin-6(IL-6) and urine lactulose/mannito (L/M) ratio were measured before and after operation.Results: Serum Gln concentration was significantly decreased in control group and increased in study group on postoperative day 5.Urine L/M ratio,serum concentrations of DAO and IL-6 were significantly increased in control group and decreased in study group.The morbidity of SIRS was significantly decreased in the study group and the score of SIRS was also lower than in the control group.Conclusions: Administration of Aln-Gln dipeptide can increase the level of serum Gln,decrease the intestinal permeability,maintain the intestinal barrier and attenuate the systemic inflammatory response in the early period of postoperative patients.Aln-Gln dipeptide can be used in the fast track surgery to help patients recover rapidly.
