资源描述：
《谷氨酰胺对体外循环患者肠道保护作用的临床研究.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、谷氨酰胺对体外循环患者肠道保护作用的临床研究
2、
3、
4、^(作者:单位:邮编:)作者：刘小雄，彭金华，徐建军，雷伟程【摘要】目的观察体外循环(extracorporealcirculation,ECC)患者接受谷氨酰胺(glutamine,Gin)治疗后血清二胺氧化酶(diamineoxidase,DAO)、肿瘤坏死因子(tumornecroticfactor,TNF-a)水平的变化，以初步阐明Gin促进ECC患者肠粘膜损伤修复的机制。方法将24名ECC患者随机分成Gin组(n=12)和对照组(n=12),Gin组ECC前一周开始口服麦滋林颗粒，剂量为0.50g/(kg
5、-day),对照组给予安慰剂。两组病例均按常规进行ECC术，分别于术前7天,ECC后2h,24h,72h抽外周静脉血5毫升。生化法检测血清DAO浓度，酶联免疫吸附实验(enzymelinkedimmunosorbentassay,ELISA)检测血清TNF-a浓度。结果两组患者的血清DAO、TNF-a水平在ECC前无统计学意义(P>0.05),ECC后升高(P<0.05)，并于2h达到峰值，而后下降。DAO于ECC后72h仍然高于术前，TNF-a则恢复到术前。Gin组DAO、TNF-a在ECC后2h、24h均较对照组降低（Pv0.05b结论ECC可引起患者血清DA
6、O、TNF-a升高，提示ECC可导致肠道损伤,Gln可以在一定程度上降低ECC患者血清DAO、TNF-a水平，促进肠粘膜损伤的修复。【关键词】体外循环；谷氨酰胺；二胺氧化酶；肿瘤坏死因子；肠Abstract:OBJECTIVEToobservethechangesofplasmiclevelofdiamineoxidase(DAO)andtumornecroticfactor(TNF-a)happenedafterL-Glutamine(Gin)usedorallyinthepatientsundergoingextracorporealcirculation(E
7、CC)anddiscussthemechanismofprotectiveeffectsofGinonintestinalmucosalinjurycausedbyECC.METHODS24patientsundergoingECCweredividedrandomlyintotwogroups:Gingroup(n=12)andcontrolgroup(n=12)」nGingroup,marzutene-sgranules(Gin)(0.50g/(kg-day))wasgivenforsevendaysbeforeECC.Whilethecontrolgroup
8、receivedplacebo.PlasmiclevelsofDAOandTNF-aweremeasuredatbaseline(sevendayspreoperatively)and2hours,24hours,72hoursafterECC.TheplasmicconcentrationsofDAOweredetectedbybiochemicalmethod,ofTNF-abyenzymelinkedimmunosorbentassay(ELISA)technique.RESULTSLevelsofDAOandTNF-awerenosignificantdi
9、ffereneeinbothgroupbeforeECC(P>0.05)andincreasedsignificantlyat2hours,24hoursafterECC(P<0.05)respectively,thendecreased.LevelsofDAOwerehigherat72hoursafterECCthanbeforeECC,whileTNF-areturnedtonormalat72hoursafterECC.InGingroup,DAOandTNF-alevelsweresignificantlylowerthanthoseincontrolg
10、roupat2hours,24hoursafterECC(P<0.05)respectively.CONCLUSIONTheplasmicconcentrationsofDAOandTNF-awereincreasedafterECC,whichindicatedtheintestinalmucosalinjuryhappenedduringECC,anddecreasedsignifcantlyinGingroupcomparedtocontrolgroup,whichindicatedthatGinmaybeimprovedtheintestinalmucos
11、alrep
