| 于冬梅 刘海峰 陈克研 孙莹杰 周锦△.丙氨酰谷氨酰胺对体外循环瓣膜置换术患者的肺保护作用[J].,2016,16(1):106-109 |
| 丙氨酰谷氨酰胺对体外循环瓣膜置换术患者的肺保护作用 |
| Effect of Alanyl Glutamine on Lung Protection in Patient Undergoing ValveReplacement Operation Using Cardiopulmonary Bypass |
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| DOI： |
| 中文关键词: 丙氨酰谷氨酰胺 SP-A 体外循环 瓣膜置换术 肺保护 |
| 英文关键词: Alanyl glutamine SP-A Cardiopulmonary bypass Valve replacement Lung protection |
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| 中文摘要: |
| 目的：探讨丙氨酰谷氨酰胺对体外循环瓣膜置换术患者肺屏障功能的影响。方法：择期体外循环（cardiopulmonary bypass，
CPB）下行心脏瓣膜置换术患者60 例，随机分为3 组，每组20 例，分别为生理盐水组（C 组）、复方氨基酸注射液组（A 组）和
Ala-GLn 组（G 组）。G 组泵注丙氨酰谷氨酰胺0.4 g/（kg·d），A 组和C 组分别泵注等量的复方氨基酸注射液和生理盐水，三组均持
续输注24 h。分别于：麻醉后(T0)、开胸后CPB 前（T1）、主动脉开放30 min（T2）、关胸(T3)、术后5 h(T4)、术后24 h(T5)、术后48 h(T6)，
经静脉采血3 mL，检测血浆IL-6、TNF-alpha 和SP-A 的含量；采动脉血进行血气分析；观察ICU 机械通气时间。结果：与T0 比较，三
组患者在T2、T3、T4、T5时间点的血清TNF-alpha和IL-6 含量均显著升高（P<0.05）；G 组患者血清TNF-琢和IL-6 的浓度显著低于C 组
和A 组（P<0.05）；与T0 比较，三组患者在T2~T5各时间点的SP-A 水平显著升高(P<0.05)，G组患者血清SP-A 含量显著低于C 组
和A 组（P<0.05）；与T0 比较，三组患者在T2~T5时的RI 值显著升高（P<0.05），G 组患者RI 值显著低于C 组和A 组（P<0.05）；G
组的机械通气时间比C 组和A 组显著缩短（P<0.05）。结论：丙氨酰谷氨酰胺能降低体外循环瓣膜置换术患者的炎症反应，保护肺
泡屏障功能，具有一定的肺保护作用。 |
| 英文摘要: |
| Objective:To investigate the effects of alanyl glutamine on alveolar barrier function in patient undergoing valve replacement
operation using cardiopulmonary bypass(CPB).Methods:60 patients undergoing valve replacement operation using cardiopulmonary
bypass were randomly divided into 3 groups (n=20 each group): alanyl glutamine group(group G), compound amino acid injection
group(group A) and normal saline (group C ). In group G, alanyl glutamine 0.4 g/（kg·d）were infused. Group A and group C were
respectively infused compound amino acid injection and saline. The infusion time was 24 h. 3 mL venous blood was taken for IL-6,
TNF-琢and SP-A detection accompanied by arterial blood gas analysis at time between anesthesia and preoperative (T0), between open
chest and CPB (T1), after opening of aorta 30 min（T2）, at the end of operation（T3）, 5 hours after the operation (T4), 24 h after the operation
(T5), and 48 h after the operation (T6). The mechanical ventilation time was observed in ICU.Results:Compared with T0, the level of
TNF-alpha and IL-6 in the three groups at T2, T3, T4, T5 point were notable raised (P<0.05). Compared with group C and group A, the level of
TNF-alpha and IL-6 in group G was significantly lower (P<0.05). Compared with T0, the SP-A level in the three groups was increased at T2 to
T5 (P<0.05). The serum SP-A protein concentration in group G was significantly lower than group A and group C (P<0.05). Compared
with T0, the RI values in the three group were significant increased at T2～T5 (P<0.05); the RI values in group G were sig- nificant lower
than group C and groupA (P<0.05). The time of mechanical ventilation in group G was significant shorter than group C and group A
(P<0.05).Conclusion:Alanyl glutamine can decrease the inflammatory response, protect alveolar barrier function, thus protect the lung
frominjury. |
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