Effects of Glutamine Supplementation on Patients Undergoing Abdominal Surgery

作     者：Yue-Dina Fan Jian-chun Yu Wei-ming Kang Qun Zhang 

作者机构：Department of Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China 

出 版 物：《Chinese Medical Sciences Journal》 (中国医学科学杂志（英文版）)

年 卷 期：2009年第24卷第1期

页      面：55-59页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 1010[医学-医学技术（可授医学、理学学位）] 100215[医学-康复医学与理疗学] 10[医学] 

主　　题：glutamine dipepfide glutathione total parenteral nutrition abdominal operation 

摘      要：Objective To evaluate the effects of supplementation of glutamine （GLN） on maintaining glu- tathione （GSH） level, immune system function, liver function, and clinical outcome of patients receiving abdominal operation. Methods Forty patients undergoing elective abdominal surgical treatment were randomly divided into 2 groups： study group （n=20） and control group （n=20）. All patients received total parenteral nutrition （TPN） for up to 7 days during perioperative period. The study group received TPN supplemented with GLN dipeptide while the control group received TPN without GLN dipeptide. Patients in both groups received equivalent nitrogen and caloric intake. Blood sample was taken on preoperative day, and the 1st, 3rd, 6th postoperative day to measure GSH level, immune indexes, and liver function indexes. Results The decrease of GSH level in plasma and red blood cell （RBC） in study group was less than that in control group during postoperative period. Ratio of GSH/glutathione disulfide （GSSG） in plasma in study grouP was higher than that in control group on the 3rd postoperative day （52.53±11.46 vs. 31.43±7.27, P = 0.001）. Albumin level in study group was higher than that in control group on the 3rd postoperative day （37.7±3.8 g/L vs. 33.8±4.2 g/L, P = 0.02）. There was no significant difference in the levels of immunoglobin （IgG, IgM, IgA） or T lymphocyte subgroup （CD4, CD8, CD4/CD8） in both groups during postoperative period. There was one case with infectious complication in control group, while none in study group. A trend of shortened hospital stay was observed in study group compared with control group （22.3±2.1 d vs. 24.9±1.7 d,P= 0.32）. Conclusions Supplementation of GLN-enriched TPN has beneficial effects on maintaining GSH levels in plasma and RBC, sustaining GSH/GSSG ratio and albumin level, and keeping antioxidant abilities during postoperative period in patients with abdominal operation, with the trends of decreasing incidence of infectious complicati