[Effects on glutathione of patients received glutamine dipeptide enriched parenteral nutrition post abdominal surgery].
OBJECTIVE
To observe the effects of glutamine (GLN) enriched parenteral nutrition (PN) on glutathione level, immune function, liver function, infectious complication and hospital stay of patients undergone abdominal operation.


METHODS
Forty patients with abdominal surgical disease undergoing elective surgical treatment were randomly divided into two groups (study and control group). All patients received total parenteral nutrition (TPN) for up to 7 days perioperatively. The control group received TPN while the study group received TPN including GLN dipeptide. Both groups received isonitrogen and isocaloric nutrition. Nonprotein caloric intake is 83.6 kJ.kg(-1).day(-1), glycogen: lipid ratio is 7:5, nitrogen intake is 0.16 g.kg(-1).d(-1), calories:nitrogen ratio is 489 kJ:1 g.


RESULTS
The decreasing degree of glutathione levels of plasma and red blood cell in study group is lower than that in control group postoperatively. GSH/GSSG ratio of plasma in study group is higher than that in control group on 3rd day postoperatively (53 +/- 11 vs 31 +/- 7, F = 4.725, P = 0.001). Albumin (ALB) of both groups decreased slightly postoperatively. ALB level of study group was higher than that of control group on 3rd day postoperatively [(3.8 +/- 0.4) g.dl(-1) vs (3.4 +/- 0.4) g.dl(-1), F = 2.128, P = 0.02]. No significant differences were noted between immunoglobin (IgG, IgM and IgA) and T lymphocyte subgroup (CD4, CD8, CD4/CD8) levels of both groups postoperatively. There was no infectious complication in study group, while one in control group. There was shorten trend of hospital stay in study group compared with control group [(22.3 +/- 2.1) d vs (24.9 +/- 1.7) d, t = -0.935, P = 0.32].


CONCLUSIONS
Glutamine enriched PN has the trend of maintaining glutathione level of plasma and red blood cell in patients having undergone abdominal operation, and can sustain GSH/GSSG ratio and ALB level, protect antioxidant ability, promote liver function postoperatively. Glutamine enriched PN has the trend of shortening hospital stay, decreasing incidence of infectious complication.
Fan
Yue-ping
YP
Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
Yu
Jian-chun
JC
Kang
Wei-ming
WM
Zhang
Qun
Q
D000005:Abdomen / Q000601:surgery; D000368:Aged; D004151:Dipeptides / Q000008:administration & dosage*; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D005978:Glutathione / Q000378:metabolism*; D019803:Glutathione Disulfide / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period
D004151:Dipeptides; D005973:Glutamine; D005978:Glutathione; D019803:Glutathione Disulfide