摘要
目的 研究力肽对严重烧伤患者肠粘膜的保护作用。方法 2001年2月-2003年2月期间我科收治的36例患者,烧伤面积50～70%,III度>30%,采用随机双盲设计,分为常规TPN治疗组(A组)、力肽+TPN治疗组(B组)。两组患者均于休克期度过平稳后接受等氮等热卡的肠外营养治疗,A组按常规给予TPN,B组按常规给予TPN并给予力肽0.5 g/kg,共14天。两组患者均于伤后3～5天行创面切痂植皮术。伤后1、4、7、15天检测尿乳果糖/甘露醇比值(L/M)、血浆二胺氧化酶(DAO)、D-乳酸(D-Lactated)、内毒素(LPS)浓度及伤后30天创面愈合率和总住院时间。结果 严重烧伤后,尿乳果糖/甘露醇比值(L/M)、血浆二胺氧化酶(DAO)、D-乳酸(D-Lactated)、内毒素(LPS)浓度显著升高;力肽+TPN治疗组(B组)患者尿L/M比值、血浆LPS、DAO、D-lactated浓度显著低于TPN治疗组(A组)(p<0.05),30天创面愈合率显著高于TPN治疗组,总住院时间显著降低。结论 严重烧伤后在给予TPN治疗的同时辅以力肽,能显著改善肠粘膜障功能,减轻内毒素移位程度,促进创面愈合速度,缩短患者住院时间。
Objective To investigate the protevtive effect of Dipeptiven, N(2)-L-Alanyl-L-Glutamine,on intestinal mucosal barrier function in severe burned patients. Methods 36 patients , aged18-60, with50%-70% TBSA and/or with 30% full thickness burn area, admitted in our burn center from Feb 2001 to Feb2003, a randomly double-blind protocol was desigened, were divided into common TPN treatment group (GroupA, N=16) and Dipeptiven(0.5/kg)+TPN treatment group(Group B, N=20), all patients were received the abovetreatment daily with isonitrogen and isocaloric pareteraal nutrition for 14 days and operation on third-5ifth day postburn. The urine lactulose/mannitol(L/M) test was performed and the plasma LPS content andcativity of diamine oxidase(DAO)and concentration of D-Lactate were determined at 1,4,7,15d postburn,wound healing rate of burn area on 30th PBD was observed and hospital stay was recorded. Results Theurine L/M ratio and the plasma LPS content and activity of diamine oxidase(DAO)and concentration of D-Lactate were markedly increased after severe burned, while treated with dipeptiven, all indes above-mentioned were significantly lower than that of in Group A, In addition, the wound healing rate of burnarea was markedly faster and hospital stay was obviously shorter than in Group A, Conclusion Treatmentof TPN with Dipeptiven was beneficial to improvement of intestinal mucosal barrier and reduction hospitalstay.
出处
《国际医药卫生导报》
2003年第12期20-22,共3页
International Medicine and Health Guidance News
关键词
力肽
肠粘膜屏障
严重烧伤
Dipeptiven intestinal mucosal barrier severe burned
