【摘要】 术后接受胃肠外营养(PN)的患者,营养液中加入谷氨酰胺双肽可以改善氮平衡。动物研究表明,谷氨酰胺具有保护胃肠结构和功能。但在人体情况如何,不得而知。选择20名住院患者并随机分为甘氨酸-谷氨酰胺双肽强化的胃肠外营养组(GlnPN)或标准胃肠外营养组(SPN)。开始胃肠外营养前在十二指肠降部取样做粘膜活检,于胃肠外营养2周后再取样活检一次。2周后Gin PN组小肠粘膜通透性未发生改变,而SPN组小肠粘膜通透性发生明显改变;Gln PN组绒毛高度未发生变化;SPN组绒毛高度有所减低。胃肠外营养液中加入谷氨酰胺双肽可预防小肠粘膜通透性的恶化和保护小肠粘膜结构。更多还原

【Abstract】 Parenteral glutamine dipeptide improves nitrogen balance in postoperative patients on total parenteal nutrition (TPN). Animal studies show that the structure and functions of the gut is preserved by glutamine. It is not known if this is the case in human beings. 20 patients ad-mitted to hospital for total parenteral nutrition were randomly allocated to receive parenteral nutri-tion enriched with glycyl-L-glutamine (Gln PN), or standard parenteral nutrition (SPN). Mucos-al biopsy specimens were taken from the second part of the duodenum before starting parenteral nutrition, and after two weeks. The ratio between the urine concentrations of lactulose and man-nitol after enteral administrations was used to measure intestinal permeability. After two weeks of parenteral nutrition in the Gln PN group, intestinal permeability was unchanged, whereas perme-ability in SPN group increased. Villus height was unaltered in the Gln PN group but in the SPN group it decreased. The addition of glutamine to parenteral nutrition prevents deterioration of gut permeability and preserves mucosal structure.更多还原