谷氨酰胺在早产儿肠外营养中的应用研究

目的研究谷氨酰胺(Gln)对早产儿的生长发育、胃肠功能成熟及感染发生率的影响。方法将35例早产儿分为两组,Gln组给予经静脉添加Gln的肠外营养(PN),对照组常规 PN,PN时间均大于2周。监测两组生长发育、喂养耐受情况、胃肠功能及感染发生率。结果 Gln 组生后4周时尿素氮(BUN)水平较对照组高(P=0．044),但仍在正常范围内。平均PN及平均住院时间Gln组均明显短于对照组(P=0．031;P=0．020)。血清胃动素水平Gln组生后2周较生后 3天明显升高(P=0．037);Gln组生后2周较生后3 d胃电节律中节律过快的百分数明显增加 (P=0．017)。Gln组发生感染的次数较对照组明显减少(P=0．001)。结论初步观察提示Gln 有助于早产儿胃肠功能的成熟,减少院内感染的发生。

Effects of glutamine-supplemented parenteral nutrition on premature infants

Objective To investigate the effects of glutamine-supplemented parenteral nutrition (PN) in premature infants on growth and development, gastrointestinal function, and the incidence of infectious episodes. Methods Thirty-five premature infants were assigned to two groups, glutamine group received glutamine-supplemented PN (glutamine took 20% of amino acid intake at the given day) , and control group received routine PN. PN lasted longer than two weeks. The differences in growth and development, enteral feeding tolerance, gastrointestinal function and infectious episodes in two groups were monitored and compared. Results Serum blood urea nitrogen was higher in glutamine group 4 weeks after birth (P=0.044) , but still in normal range. The average PN duration and hospitalization period were significantly shorter in glutamine group (P =0.031;P =0.020). Serum motilin level in glutamine group became higher on the second week than on the third day(P=0. 037). Electrogastrography indicated that the fast waves increased in glutamine group on the second week than on the third day (P=0.017). The infection episodes of glutamine group were significantly less than those in control group (P =0.001).Conclusions Our initial study proves that glutamine supply is helpful to the maturation of the gastrointestinal function and the decrease of nosocomial infection incidence.