谷氨酰胺在重度烧伤中的应用研究进展  

Research Progress of Glutamine in Major Burn Injury

作　　者：段海娥 王驰[1] 白瑞雪 杨跃辉[1] DUAN Haie;WANG Chi;BAI Ruixue;YANG Yuehui(Department of Pharmacy,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院药学部,沈阳110004

出　　处：《药学与临床研究》2020年第5期375-378,共4页Pharmaceutical and Clinical Research

摘　　要：近期的临床试验数据和荟萃分析显示,谷氨酰胺有减少重度烧伤患者死亡率、缩短住院时间、减少感染率等临床益处。其作用机制包括代谢应激状态下的组织保护,减弱胰岛素抵抗,维护肠屏障功能,免疫调节作用以及器官保护等。各医药学会"指南"虽对重度烧伤病人应用谷氨酰胺作出推荐,但是循证证据较低。目前,相关随机对照试验多为单中心、小样本的研究,其中对其剂量、给药途径、治疗时间和适用人群缺乏统一认识。在重度烧伤患者中应用谷氨酰胺的证据尚不够充分,需要更多的证据予以支持。Major burn injury leads to a marked deficiency in glutamine that is correlated with mortality.Updated initial clinical trial data have shown that giving glutamine reduced mortality,hospital length-of-stay and infection rate in major burn-injured patients.The mechanism,including tissue protection in stress state,reduction of insulin resistance,maintenance of intestinal barrier function,anti-inflammation,immune regulation and organ protection,has been widely studied.However,the evidence-based results are not sufficient.Current related randomized controlled trials are mostly single-center,small-sample studies,lacking a unified understanding of glutamine dose,administration route and duration of treatment.A double-blind,multicenter,pragmatic RCT is being conducted and the results are expected by 2021,which will provide more evidence for the application of glutamine in major burn injury.

关 键 词：重度烧伤 谷氨酰胺 免疫营养素 感染 死亡率 

分 类 号：R961[医药卫生—药理学] R977.4[医药卫生—药学]