Effects Of Glutamine Intensified Parenteral Nutrition Support On Systematic Inflammatory Response Syndrome In Surgical Patients

Objective:To evaluate the effect of glutamine (Gln) intensified parenteral nutrition support on nutrition, host immune and acute inflammatory responses in the surgical patient's with systemic inflammatory response syndrome (SIRS)Methods:Thirty-six cases surgical patients with SIRS were involved in a randomized controlled prospective clinical trial, and divided into Gln group and control group. All patients were treated with routine surgical treatment combined with parenteral nutrition. 18 cases in Gln group were treated with Gln supplied by 20%L-Ala- Gln solution 100ml , and another 18 cases in control group were not given. All patients were observed for 7 days. The data about serum proteins, acute inflammatory responses and immune function were analyzed.Results:After used TPN seven days,①T here were no significant differences in changes of the levels of serum albumin and hemoglobin between 2 groups (P>0.05), but the level of prealbumin increased more in Gln group than in control group (P<0.05).②The number of LYM in blood and the level of serum IgG,IgA,CD4,CD4/CD8 increased more in Gln group than in control group( P<0.05) ,but IgM,CD8 maintained unchanged in two groups. The level of serum CRP decreased more in Gln group than in control group (P<0.05).③The scores of acute physiology and chronic health evaluation (APACHEⅡ) and the level of serum CRP,IL-6,IL-8,TNF-αdecreased significantly in two groups (P<0.05), and the decrease in Gln group was more obvious than in control group (P<0.05).Conclusion:glutamine intensified parenteral nutrition support has better effects on improvement of the patient's nutrition ,protein metabolism and immune function, and it relieves degree of acute inflammatory response of the surgical patients with SIRS and it benefits to resume function of cell and organs.