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[目的]观察谷氨酰胺辅助治疗对新生儿上消化道出血氧化应激的影响,并分析其临床疗效。[方法]选取2013年6月~2016年3月我院收治的上消化道出血新生儿96例,使用数字法随机分为对照组和谷氨酰胺辅助治疗观察组,每组48例。对照组使用0.8mg/Kg奥美拉唑静滴,2次/d。观察组在对照组基础上加用100mg/Kg谷氨酰胺颗粒口服,3次/d,3d为一疗程。治疗结束后比较2组超氧化物歧化酶(SOD)活性、丙二醛(MDA)、临床疗效和不良反应发生率的差异。[结果]治疗前2组患儿SOD和MDA差异无统计学意义(P>0.05),治疗后2组SOD均显著升高和MDA均显著减低(P<0.05或P<0.01),但治疗后观察组对SOD的升高作用以及对MDA的减低作用显著优于对照组(P<0.05)。观察组患儿止血停止时间为(15.34±3.42)h,显著低于对照组的(23.25±5.26)h(P<0.05)。观察组患儿隐血试验转阴时间为(31.34±6.23)h,显著低于对照组的(56.47±11.26)h(P<0.01)。观察组的临床治疗有效率为93.8%(45/48),显著优于对照组的81.3%(39/48)(P<0.05)。观察组临床治疗不良反应率为8.3%(4/48),对照组临床治疗不良反应率为6.3%(3/48),2组间差异无统计学意义(P>0.05)。[结论]谷氨酰胺可抑制上消化道出血新生儿的氧化应激反应,对胃黏膜损伤组织具有一定的保护作用,临床疗效显著,使用安全。
[Objective] To observe the effect of glutamine adjuvant therapy on oxidative stress in neonates with upper gastrointestinal hemorrhage and analyze its clinical efficacy. [Methods] Ninety-six neonates with upper gastrointestinal bleeding admitted to our hospital from June 2013 to March 2016 were randomly divided into control group and glutamine adjuvant treatment group (n = 48). The control group used 0.8mg / Kg omeprazole intravenous infusion, 2 times / d. The observation group was treated with glutamine granules 100mg / Kg on the basis of the control group orally, 3 times / d, 3d for a course of treatment. After treatment, the differences of SOD activity, malondialdehyde (MDA), clinical efficacy and incidence of adverse reactions between the two groups were compared. [Results] There was no significant difference in SOD and MDA between the two groups before treatment (P> 0.05). After treatment, both SOD and MDA were significantly decreased (P <0.05 or P <0.01), but after treatment The effect of SOD in the observation group and the reduction of MDA were significantly better than those in the control group (P <0.05). The stopping time of hemostasis in observation group was (15.34 ± 3.42) h, which was significantly lower than that in control group (23.25 ± 5.26) h (P <0.05). Occult blood test in the observation group turned out to be (31.34 ± 6.23) h, which was significantly lower than that of the control group (56.47 ± 11.26) h (P <0.01). The clinical efficacy of the observation group was 93.8% (45/48), which was significantly better than that of the control group (81.3%, 39/48) (P <0.05). Adverse reaction rate was 8.3% (4/48) in the observation group and 6.3% (3/48) in the control group. There was no significant difference between the two groups (P> 0.05). [Conclusion] Glutamine can inhibit the oxidative stress in neonates with upper gastrointestinal hemorrhage and has protective effect on gastric mucosal lesion. The clinical effect is obvious and safe to use.