谷氨酰胺双肽强化的静脉营养促进烧伤创面愈合的机制

目的探讨静脉补充谷氨酰胺双肽促进烧伤患者术后创面愈合的可能机制。方法30例烧伤总面积10％～30％，Ⅲ度烧伤面积≥1％的患者随机进入对照组和研究组，每组15例。两组在手术后接受静脉营养治疗7d，研究组接受静脉谷氨酰胺双肽0．5g·kg^-1·d^-1。分别检测术前1天和术后第7天患者的血浆游离羟脯氨酸浓度，统计术后创面愈合时间。结果对照组和研究组的术前血浆游离羟脯氨酸浓度分别为（2．24±0．84）和（2．32±0．92）μg／ml，均高于正常值的（1．27±0．44）μg／ml，但是差异无统计学意义。术后第7天对照组和研究组的血浆游离羟脯氨酸浓度分别为（3．04±1．01）和（4．31±1．05）μg／Ⅲ，均高于手术前水平，研究组的血浆游离羟脯氨酸浓度显著高于对照组（P=0．002）。研究组的创面愈合时间为（29.7±5．3）d，短于对照组的（33．3±7．5）d，但差异无统计学意义（P=0．14）。结论静脉补充谷氨酰胺双肽有助于提高烧伤患者术后血浆游离羟脯氨酸浓度，可能对创面愈合有促进作用。

Mechanism of supplementation of glutamine dipeptide on improving wound healing after operation on burns

Objective To study the mechanism of glutamine dipeptide on wound healing after operations on bums. Methods Totally, 30 burned patients were randomly divided into study group and control group (15 cases in each group). All patients received parental nutrition support after operation. Study group patients were supplemented with glutamine dipeptide at a dose of 0. 5 g ·kg-1· d-1. The plasma free hydroxyproline level was measured by a standard amino acid analyzer 1 day before operation and 7 days after operation and the wound healing time was recor- ded. Results The plasma free hydroxyproline levels of both groups were higher than the normal values before opera- tion but without significant difference [control group: (2. 24±0. 84) μg/ml, study group: (2. 32±0.92) jig/ml, normal value: (1.27±0.44) μg/ml]. On the post-operative 7 day, the plasma free hydroxyproline level of study group [ (4. 31±1. 05) ng/ml] was significantly higher than that of control group [ (3. 04±1. 01) μg/ml] (P = 0.002). The wound healing time of study group [ (29. 7±5.3) d] was shorter than that of control group but with- out significant difference [ (33. 3±7.5) d, P = 0. 14 ]. Conclusion The intravenous supplementation of glutamine dipeptide may increase the plasma hydroxyproline level after operation and thus promote wound healing.