谷氨酰胺双肽对肝硬化患者肠屏障功能的影响

目的评价肝硬化患者肠黏膜屏障功能及静脉补充谷氨酰胺双肽对其的影响。方法43例肝硬化患者随机分为两组，均给予等氮等热量营养支持10d；研究组22例，给予谷氨酰胺双肽0．3g／（kg·d），剩余氮量由平衡氨基酸提供；对照组21例，仅由平衡氨基酸提供氮源。采用分光光度法定量检测两组患者治疗前后外周血中二胺氧化酶（DAO）和内毒素（ETX）水平。另以15例健康志愿者作为正常组。结果肝硬化患者组DAO及ETX水平显著高于正常组（P〈0．01）；研究组治疗后血DAO及ETX水平较治疗前显著降低（P〈0．05），且显著低于对照组治疗后水平（P〈0．05）；肝硬化患者血DAO与ETX水平呈正相关（r=0．269，P〈0．05）；两组治疗过程中均未见明显不良反应发生。结论对肝硬化患者补充谷氨酰胺双肽可能有助于改善肠黏膜屏障功能，从而减少内毒素血症的发生．使用过程相对安全。

Effects of glutamine on intestinal barrier in cirrhosis patients

Objective To evaluate the function of intestinal mucosa barrier in cirrhosis patients and the effects of alanyl-glutamine dipeptide supply on intestinal mucosa barrier in cirrhosis patients. Methods Forty-three patients were randomly divided into two groups： study group（ 22 cases） and control group（21 cases）. All of the patients received isocaloric and isonitrogenic parenteral nutritional support daily for 10 days. The patients in study group were given glutamine at the dose of 0. 3 g/（ kg · d） , while the patients in control group were given conventional common amino acid at the same dose. The normal group included 15 healthy people. The serum levels of DAO and ETX in 43 cirrhosis patients were detected before and after treatment by spectrophotometry in each group. Results The levels of DAO and ETX in cirrhosis group were significantly higher than those in normal group（P 〈0. 01 ）. After treatment, the serum levels of DAO and ETX in study group decreased （ P 〈 0. 05 ）. Moreover, these were significantly lower than those in control group （P 〈 0.05 ）. The serum level of DAO was correlated with the level of ETX in cirrhosis patients （ r = 0. 269, P 〈 0.05 ）. There was no adverse reaction during treatment. Conclusions Alanyl-glutamine dipeptide is safe and beneficial for cirrhosis patients, which may be helpful to improve the function of intestinal mucosa barrier and reduce the incidence of endotoxemia.