全胃切除术后给予含谷氨酰胺双肽的肠外营养对机体蛋白合成的影响

目的探讨全胃切除术后给予谷氨酰胺双肽的肠外营养对机体蛋白合成的影响。方法24例胃癌患者根据病情均行根治性全胃切除术，术后随机分为对照组和实验组，每组12人。两组病人均接受等氮热卡的肠外营养一周，实验组接受含丙氨酰-谷氨酰双肽的补充(0.3g/kg)。在术前及术后第1天、第8天分别取血测定总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TEN)。结果术后第1天两组TP、ALB、PA、TEN均较术前下降，术后第8天实验组血浆蛋白水平恢复较快，TP、PA、TEN水平均高于术前(P<0.05)。而对照组恢复较慢，上述指标前后无显著性变化(P>0.05)。两组间相比，实验组TP、PA、TEN明显高于对照组(P<0.01)。结论全胃切除术后给予含谷氨酰胺双肽的肠外营养能够促进机体蛋白质的合成，降低蛋白质分解，改善患者的营养状况。

The effect of parenteral nutrition containing glutamine on protein synthesis after total gastrectomy

Objective To investigate the effect of parenteral nutrition thatcontaining alanyl glutamine on protein synthesis after radical total gastrectomy. Methods Twenty-four patients with gastric cancer in the postoperative period were divided randomly into two groups:control group(12 patients) and study group (12 patients).Both groups received the nutrition that equivalent in caloric and nitrogen except study group which specially got alanyl glutamine (0.3g/kg/day).Total proteins (TP),Albumin (ALB),Prealbumin (PA),and Transferrin (TEN) were determined in the day before operation and on the 1st,8th postoperative day. Results TP,ALB,PA and TEN were decreased on 1st postoperative day compared with preoperative period in both group.Serum proteins return to normal faster in study group than in control group on 8th postoperative day.TP,PA,TEN were greatly increased and were significant differences from control group (P<0.05).Compare with the control group,TP,PA and increased significant in group in study group (P<0.01).The differences bwtween data in pre-and in postoperative period were not significant in control group (P>0.05). Conclusions Alanyl glutamine containing in parenteral nutrition can accelerate protein synthesis,retard protein decomposition,and improve nutritional status.