【作者】 周业平； 孙永华； 蒋朱明； 何桂珍； 杨乃发；

【Author】 Zhou yeping, Sun yonghua, Jiang zhuming, He guizhen, Yang naifa Department of burn, Beijing Jishuitan Hospital, 100035, Departments of Surgery, Peking Union Medical Collage Hospital, 100730, Beijing, P.R. China.

【机构】 北京积水潭医院烧伤科北京市烧伤研究所； 北京协和医院外科；

【摘要】 目的:探讨谷氨酰胺双肽对烧伤病人血浆内毒素水平的影响。方法:30例烧伤面积30％～ 70％,III度面积>20％的患者随机分为对照组(Control group)和研究组(Study group),研究组1～12 天口服谷氨酰胺双肽粉剂0．5g．kg-1．day-1,检测伤后1,12天血浆谷氨酰胺浓度,1,3,6,12天血浆内毒素的浓度,记录30天创面愈合率和总住院日。用统计软件SPSS10．0比较两组的差异,p<0．05视为有显著性差异。结果:伤后第1天两组血浆谷氨酰胺浓度明显下降(Control:283．07±32．21 um／l, Study:277．51±28．36 um/l,p=0．91),第12天对照组仍在低浓度而研究组则接近正常(Control:401.67 ±65．42 um/l,Study:593．47±68．51),组间差异显著(p=0．022)。血浆内毒素浓度伤后第1天均明显升高(Control:0．079±0．017,Study:0．088±0．019,p=0．45),第3天研究组内毒素浓度低于对照组 (Control:0．107±0．038,Study:0．047±0．017eu／ml),组间有显著性差别(p=0．021)。结论:口服谷氨酰胺双肽可以维持烧伤患者血浆谷氨酰胺浓度,降低内毒素值,增加30天创面愈合率,缩短住院日。更多还原

【Abstract】 Aim:To determine the effects of oral glutamine dipeptide on improving endotoximea in severe burns. Methods: 30 severe burn patients were randomized into control group & study group. Study group patients were given oral glutamine dipeptide by a dose of 0.5 g. kg -1. d -1 ( equivalent to L- glutamine 0.35g.kg-1 .d-1) from the post of burn day 1 (PBD + 1) to PBD + 12 after burn, placebo were given to control group patients. On PBD+ 1, + 12 the plasma amino acid was measured by a standard amino acid analyzer. On PBD +1, + 3, +6, +12, the plasma endotoxin were detected with limulus lysate assay, and then wound healing rate of burn area was detected on PBD + 30 and the length of hospital stay was recorded. SPSS 10.0 was used for data analysis. Results: The plasma GLN concentration decreased in all patients at PBD+ 1 (Control: 283.07 + 32.21 um/l, Study: 277.51+28.36 um/l, p = 0.91), On PBD+ 12the study group increased compared with control (Study: 593.47±68.51 um/L, Control: 401.67±65.42um/L), the difference was significant (p = 0.022) . The plasma endotoxin concentration increased in both groups on PBD + 1 (Control: 0.079 ± 0.017eu/ml, Study: 0.088±0.019 eu/ml, p = 0.45), The Study group decreased and become lower than control on PBD + 3 (control: 0.107 ± 0.038eu/ml, study: 0.047 ± 0.017eu/ml, p = 0.021), The wound healing rate on PBD + 30 and length of hospital stay was both favorite in study group. Conclusion: The oral glutamine dipeptide has good effect on improving the plasma glutamine level after severe burns, decreasing the endotoxin level, ameliorating wound healing rate at day 30, shorten the length of hospital stay.更多还原