谷氨酰胺联合维生素C对军事训练中暑及内毒素血症的预防作用及机制研究  

Preventive effect of combined glutamine and vitamin C on heat apoplexy and endotoxemia in military training and its mechanism

作　　者：牟东[1] 薛世祥[1] 代剑华[1] 赵海霞[1] 袁月[1] 彭贵勇[1] 

机构地区：[1]第三军医大学西南医院全军消化病研究所,重庆400038

出　　处：《第三军医大学学报》2010年第23期2503-2506,共4页Journal of Third Military Medical University

基　　金：第三军医大学科研创新基金(2009XYY17)~~

摘　　要：目的观察谷氨酰胺联合维生素C对中暑及肠源性内毒素血症的干预作用,初步探讨其作用机制。方法对48例在高热环境下进行军事训练的士兵按照区组随机化法分为预防组(24例)和对照组(24例),预防组士兵在常规口服补液的基础上加服谷氨酰胺联合维生素C预防中暑,对照组采用相同的常规补液加服安慰剂。比较2组中暑发生率,训练前后氧化应激指标、血浆内毒素、十二指肠粘膜超微结构及十二指肠粘膜热休克蛋白70(HSP70)表达变化。结果药物预防组和对照组中暑的发生率分别为8.3%(2/24)和33.3%(8/24),差异具有统计学意义(P<0.01);药物预防组较对照组血清超氧化物歧化酶(SOD)水平升高,血清丙二醛(MDA)及血清内毒素降低,差异均有统计学意义(P<0.01);透射电镜观察药物预防组十二指肠粘膜微绒毛、细胞器、内质网基本正常,对照组十二指肠粘膜多数微绒毛紊乱,细胞器、内质网均有肿胀,免疫组化结果表明药物预防组HSP70表达较对照组明显升高。结论谷氨酰胺联合维生素C可为小肠修复提供能量来源,提高热休克蛋白对小肠粘膜的保护作用,同时减轻氧化应激反应,从而保护小肠的屏障功能,降低肠源性内毒素血症发生。可用于中暑的预防性治疗。Objective To observe the intervention effect of combined glutamine and vitamin C on heat apoplexy and enterogenous endotoxemia and its mechanism. Methods Forty-eight soldiers at military training in high temperature environment were divided into heat-apoplexy treatment group （n=24） and control group （n=24）. Soldiers in heat-apoplexy treatment group were treated with combined glutamine and vitamin C plus routine oral fluid, while those in control group were given routine oral fluid and placebo. Incidence of heat apoplexy, oxidative stress index, plasma endotoxin, ultra-structure of duodenal mucosa and expression of heat shock protein 70 （HSP70） in duodenal mucosa were compared before and after training. Results The incidence of heat apoplexy was 8.3% （2/24） and 33.3% （8/24） in heat-apoplexy treatment group and control group, respectively （P0.01）. The level of superoxide dismutase （SOD） was higher while the serum level of malondialdehyde （MDA） and endotoxin was lower in heat-apoplexy treatment group than in control group （P0.01）. Transmission electron microscopy showed that the villi, orgaelles and endoplasmic reticulum of duodenal mucosa were almost normal in heat-apoplexy treatment group. However, the villi were arranged in disorder with enlarged orgaelles and endoplasmic reticulum of duodenal mucosa in control group. Immunohistochemistry showed that the expression level of HSP70 was significantly higher in heat-apoplexy treatment group than in control group. Conclusion Glutamine in combination with vitamin C can provide the energy for the repair of small intestine, increase the protective effect of HSP70 on small intestine, and reduce the incidence of oxidative stress reaction, thus protecting the barrier function of small intestine and decreasing the occurrence of enterogenous endotoxemia. It can thus be used in prevention of heat apoplexy.

关 键 词：谷氨酰胺 维生素C 中暑 内毒素 热休克蛋白 

分 类 号：R825[医药卫生—临床医学] R969