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目的观察谷氨酰胺对肝脏手术后缺血再灌注肠道功能的影响。方法将40只新西兰兔采用Pringle法进行持续性肝门阻断,持续时间30min后随机分为试验组与对照组各20只。试验组术前12h及术后给予谷氨酰胺溶液(300mg/kg)腹腔内注射,每天2次;对照组同期给予等量生理盐水腹腔内注射。分别于阻断前和阻断再灌注后4h、24h各取10只新西兰兔,测定肠道组织中的丙二醛(MDA)水平、超氧化物歧化酶(SOD),检测血浆中的肿瘤坏死因子-α(TNF-α)及内毒素水平,比较2组该3个指标的水平变化情况。结果再灌注后4h,2组新西兰兔肠组织MDA、TNF-α及内毒素水平增高,SOD水平下降;再灌注后24h MDA、TNF-α及内毒素水平较再灌注后4h降低,而SOD水平较再灌注后4h上升。而试验组再灌注后4、24h的SOD、MDA、TNF-α及内毒素水平变化幅度均小于对照组,差异均有统计学意义(P<0.05)。结论谷氨酰胺具有肠黏膜保护作用,肝脏手术后应用谷氨酰胺可以减轻缺血再灌注对肠道黏膜损伤。
Objective To observe the effect of glutamine on intestinal function after ischemia / reperfusion in liver surgery. Methods Forty New Zealand rabbits were treated with Pringle method for persistent hepatic portal vein occlusion. After lasting for 30 minutes, they were randomly divided into two groups: experimental group and control group. The experimental group was given intraperitoneal injection of glutamine solution (300mg / kg) intraperitoneally twice a day before operation and 12h after operation. In the control group, an equal volume of normal saline was injected intraperitoneally. Ten New Zealand rabbits were taken at 4 h and 24 h after occlusion and before reperfusion, respectively. Malondialdehyde (MDA), superoxide dismutase (SOD), intestinal mucosal tumor necrosis Factor-α (TNF-α) and endotoxin levels were compared between the two groups of the three indicators of the level of change. Results At 4h after reperfusion, the MDA, TNF-α and endotoxin levels were increased and the SOD level was decreased in the intestinal tissue of two groups of New Zealand rabbits. The levels of MDA, TNF-α and endotoxin were decreased 4 h after reperfusion, 4h after reperfusion. However, the changes of SOD, MDA, TNF-α and endotoxin in experimental group at 4 and 24 hours after reperfusion were all lower than those in control group (P <0.05). Conclusion Glutamine has protective effects on intestinal mucosa. Application of glutamine after liver surgery can reduce intestinal mucosal injury induced by ischemia-reperfusion.