谷氨酰胺在危重病患者中的应用

目的探讨危重病患者中早期经静脉应用谷氨酰胺（glutamine，Gl）的临床价值。方法42例患者随机分成两组（对照组和Gln组），Gln组进行Gln治疗（100mL／d，共7d）。治疗前后检测患者体质量、白蛋白、谷胱甘肽（GSH）、握力的变化和肠功能不全的发生率。结果体质量两组治疗前后比较差异无显著性（P〉0．05）。白蛋白、握力和GSH Gl治疗后非常显著高于治疗前（P〈0．01）；白蛋白对照组治疗后较治疗前显著增高（P〈0．05），但握力和GSH治疗前后均无显著变化（P〉0.05）；肠功能不全的发生率Gln组为4．8％，显著低于对照组（28．6％，P〈0．05）。结论在危重病患者疾病早期通过静脉途径外源性地补充Gln，有效改善了患者的营养状况；使患者血浆中的GSH水平增高，加强了机体的抗氧化能力；减少了患者肠功能不全的发生率。

Glutamine in critical patients

Objective To evaluate the effects of glutamine(Gln) administrated by vein in critical patients.Methods Forty-two patients were randomly divided into 2 groups,one was the control group,the other was the glutamine treatment group(glutamine 100 mg/d for 7 days).The body weight,glutathione(GSH) level,albumin level,grip strength and the ratio of intestinal dysfunction were observed before and after treatment.Results No significant changes in two groups of the body weight(P>0.05).The albumin level,the grip strength and the GSH level in the glutamine treatment group after glutamine administration was very significantly higher than that before treatment(P<0.01),and there were not significant changes in the control group for the body weight,the GSH level,and the grip strength (P>0.05).The albumin level in control group was significant improved(P<0.05).The ratio of intestinal dysfunction in the glutamine treatment group(4.8%)was significantly lower compared with that in the control group(28.6%,P<0.05).Conclusions Glutamine administrated by vein at early stage of critical patients achieved ideal effect improve patients' nutrition status;increase GSH level in plasm,then improves patients' antioxidant system;decrease the ratio of intestinal dysfunction.