Effect of glutamine on change in early postoperative intestinal permeability and its relation to systemic inflammatory response.
OBJECTIVE
To study the effects of glutamine (Gln) on the change of intestinal permeability and its relationship to systemic inflammatory response in early abdominal postoperative patients.


METHODS
A prospective, randomized, double-blind and controlled trial was taken. Twenty patients undergoing abdominal surgery were randomized into Gln group (oral administration of glutamine, 30 g/d, for 7 d, n=10) and placebo group (oral administration of placebo, 30 g/d, for 7 d, n=10). Temperatures and heart rates of all patients were daily recorded. White blood cell counts(WBC) and biochemical variables were measured before operation and 4 and 7 d after drug administration. Serum concentrations of glutamine, endotoxin, diamine oxidase and malondialdehyde and urine lactulose/mannito (L/M) ratio were measured before and 7 d after drug administration.


RESULTS
The patients in the 2 groups were comparable prior to drug administration. Serum Gln concentration was significantly decreased in the placebo group and increased in the Gln group 7 d after drug administration. Urine L/M ratio was significantly increased in the placebo group and decreased in the Gln group. The serum concentration of endotoxin, diamine oxidase and malondialdehyde was significantly decreased in the Gln group compared with those in the placebo group. Temperatures, heart rates and WBC counts were significantly lower in the Gln group than those in the placebo group.


CONCLUSIONS
Gut is one of the sources of systemic inflammatory response in abdominal postoperative patients and glutamine can decrease intestinal permeability, maintain intestinal barrier and attenuate systemic inflammatory response in early postoperative patients.
Quan
Zhu-Fu
ZF
Research Institute of General Surgery, Jinling Hospital, Medical College of Nanjing University, Nanjing 210002, Jiangsu Province, China. quanzhufu@hotmail.com
Yang
Chong
C
Li
Ning
N
Li
Jie-Shou
JS
D000005:Abdomen / Q000601:surgery; D000328:Adult; D006631:Amine Oxidase (Copper-Containing) / Q000097:blood; D001831:Body Temperature; D004731:Endotoxins / Q000097:blood; D005260:Female; D005973:Glutamine / Q000008:administration & dosage* / Q000097:blood; D006339:Heart Rate; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D007792:Lactulose / Q000652:urine; D007958:Leukocyte Count; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control; D011446:Prospective Studies; D013312:Stress, Physiological / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology
D004731:Endotoxins; D005973:Glutamine; D007792:Lactulose; D008315:Malondialdehyde; D006631:Amine Oxidase (Copper-Containing)