保存液中添加谷氨酰胺对移植小肠结构与功能的影响

目的 观察谷氨酰胺在小肠保存中的作用。方法 12只杂种猪随机分成2组，供肠分别采用含有22g/L甘氨酸（对照组，n=6)或20g/L谷氨酰胺（实验组，n=6)的Euro-Collins液保存24h，然后行自体节段小肠移植，测定保存后及再灌注30min时肠粘膜损伤Parks评分，肠粘膜谷氨酰胺含量，双糖酶活性，门静脉血中内毒素浓度和移植小肠的通透性。结果 保存24h，肠粘膜谷氨酰胺含量明显高于对照组；再灌注后30min。实验组肠粘膜的损伤明显轻于对照组，双糖酶活性明显高于对照组，而门静脉血中内毒素浓度明显低于对照组；两个组移植术后24h肠粘膜通透性均明显增加，但对照组较实验组增加更明显。结论 保存液中添加谷氨酰胺能有效地改善移植小肠的功能，降低肠粘膜的通透性，减轻肠粘膜的组织损伤程度。

Glutamine improves the structure and function of the small intestinal graft preserved by cold storage

Objective To investigate the effect of the addition of glutamine (Gln) to Euro Collins solution on the structure and function of the small bowel graft preserved by cold storage.Methods The graft was preserved by Euro Collins solution containing 22?g/L glycine (control group, n =6) or 20?g/L of glutamine (experimental group, n =6).The graft was segmental autotransplanted following 24 h cold storage .The Parks score of graft injury,the graft mucosal content of Gln,intestinal disccharidase activity,endotoxin levels of recipient portal venous plasma and the graft permeability after preservation and reperfusion for 30?min were determined. Results At the end of storage,the graft mucosal content of Gln and intestinal disccharidase activity were significantly higher in the experimental group than in the control group ( P < 0.05 );Thirty min after reperfusion,the scores of graft injury and endotoxin levels of recipient portal venous plasma were significantly lower and graft permeability to 99m Tc DTPA 24?h after operation were significantly higher in the experimental group than in the control group ( P < 0.05 ).Conclusion The addition of Gln to Euro Collins solution could decrease injury of small bowel graft induced by cold ischemia and intestinal permeability,increase intestinal content of Gln and disccharidase activity,improve structure and function of small bowel graft.