摘要
目的通过含谷氨酰胺(glutamine,Gln)的静脉营养与传统静脉营养的对比,观察Gln对小儿先天性心脏病患者术后肠道通透性、血浆白细胞介素2(IL-2)、内毒素水平和蛋白质合成作用的影响。方法将先天性心脏病患者20例按随机数字表法分成Gln组和对照组,每组10例。于术后24h每天给予两组等氮、等热卡的静脉营养,在此基础上,Gln组术后13d给予力肽(静脉用谷氨酰胺制剂)2ml/kg.24h。分别于术前、术后24h和96h测定肠道通透性,血中内毒素I、L-2、C反应蛋白、前白蛋白的含量。结果两组患者术后24h肠道通透性增大,术后96h恢复至术前水平。术后24h两组内毒素水平皆高于术前(P<0.01),术后96h Gln组恢复至术前水平,而对照组依然较高,两组比较差别有统计学意义(P<0.01)。术后24h两组血中IL-2水平较术前明显下降(P<0.05);术后96h Gln组IL-2水平升至术前,而对照组IL-2水平仍未恢复,两组比较差别有统计学意义(P<0.05)。结论Gln的应用可改善小儿先天性心脏病术后的免疫抑制,提高IL-2水平,降低血中内毒素浓度,减轻感染的发生,但未能促进术后蛋白质的合成。
Objective To observe the effect of glutamine （Gln） on intestinal permeability after surgery of children, also its influence on the plama level of interleukin-2（IL-2）, endotoxin and synthesize of protein through a random nutrition trial. Methods Twenty children suffered from congenital heart disease were divided into Gln group and control group with random number table, 10 cases in each group. They were all given isonitrogenous and isocaloric total paraenteral nutrition after 24 h postoperatively. In Gln group the Dipeptiven [-N （2）-L-alanyl-Lglutamine] was used with 2 ml/kg · 24h additionly. Before operation, 24h and 96 h after operation, intestinal permeability, serum level of endotoxin, IL-2, C-reaction protein, prealbumine were measured. Results Intestinal permeability increased in 24 h after cardiac surgery in two groups, while the concentration of endotoxin also increased, 96 h after surgery the intestinal permeability recovered, but the endotoxin level did not decrease in control group （P〈0. 01）. Conclusion Utilization of Gln can improve immune suppression, elevate the IL-2 level, decrease the endotoxin concentration, alleviate the infection, but has no effect on the protein synthesis after congenital cardiac operation of children.
出处
《中国胸心血管外科临床杂志》
CAS
2005年第6期393-395,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
